A Retrospective Chart Review of Transfusion Practices in the Palliative Care Unit Setting
A Retrospective Chart Review of Transfusion Practices in the Palliative Care Unit Setting
复制标题
姑息治疗病房输血实践的回顾性图表审查
DOI：
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
D. Selby
中科院分区：
文献类型：
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作者：
Giovanna Sirianni;G. Perri;J. Callum;S. Gardner;A. Berall;D. Selby
背景：文献中关于姑息治疗中输血的频率、临床效用和有效性的数据仍然有限，没有关于该主题的随机对照试验或临床实践指南。在这种情况下，没有适当的血液制品输血的常规可接受实践。目的：本研究的目的是回顾性分析加拿大2家三级医院姑息治疗病房的所有输血情况。目标是阐明这种干预的频率、适应症、患者特征和实践。设计：描述性、回顾性病历审查。环境/参与者：对2015年4月1日至2017年3月31日期间入住姑息治疗病房并接受输血的患者的临床图表进行了审查。纳入了所有接受输血的住院患者。无排除标准。结果如下：尽管有输血，但姑息治疗病房的输血很少（Sunnybrook为0.9%，Baycrest为1.4%），主要用于癌症患者。确定的输血主要症状问题为疲乏和呼吸困难。大多数患者认可症状获益，不良反应最小，但输血前和输血后评估实践在机构之间差异很大。结论：在姑息治疗单位输血是罕见的，针对症状，耐受性良好，虽然缺乏标准化的前/后评估工具限制了任何能力，得出结论的效用。患者将受益于这一领域的进一步研究和姑息治疗输血临床实践指南的发展。
Background: There remains limited data in the literature on the frequency, clinical utility and effectiveness of transfusions in palliative care, with no randomized controlled trials or clinical practice guidelines on this topic. There are no routinely accepted practices in place for the appropriate transfusion of blood products in this setting. Aim: The aim of this study was to retrospectively review all transfusions in the palliative care units of 2, tertiary care hospitals in Canada. The goals were to elucidate the frequency, indications, patient characteristics, and practices around this intervention. Design: Descriptive, retrospective chart review. Setting/Participants: The clinical charts of patients admitted to the palliative care unit and who obtained blood transfusions for the period of April 1, 2015, to March 31, 2017, were reviewed. All patients admitted who obtained a transfusion were included. There were no exclusion criteria. Results: Transfusions in the palliative care units were rare despite their availability (0.9% at Sunnybrook and 1.4% Baycrest) and were primarily given to patients with cancer. The main symptom issues identified for transfusion were fatigue and dyspnea. The majority of patients endorsed symptomatic benefit with minimal adverse reactions though pre- and post-transfusion assessment practices varied greatly between institutions. Conclusions: Transfusions in the palliative care units were infrequent, symptom targeted, and well tolerated, though the lack of standardized pre/post assessment tools limits any ability to draw conclusions about utility. Patients would benefit from additional research in this area and the development of clinical practice guidelines for transfusions in palliative care.