Home transfusion: three decades of practice at a tertiary care hospital
Home transfusion: three decades of practice at a tertiary care hospital
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DOI：
10.1111/trf.14816
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发表时间：
2018-10-01
期刊：
影响因子：
2.9
通讯作者：
Romon, Inigo
中科院分区：
文献类型：
--
作者：
Garcia, Dora;Aguilera, Ana;Romon, Inigo
背景家庭医院 (HH) 在患者家中提供专门护理。让患者留在家庭环境中可以带来更好的结果，减少再入院、死亡率和护理费用。家庭输血 (HT) 可能是家庭管理中的一个关键要素，但由于对安全和成本的担忧而很少部署。我们回顾了我们的 HT 实践，以评估其可行性和安全性。研究设计和方法我们前瞻性地回顾了 1985 年至 2015 年收集的数据，特别关注可行性和程序安全性，寻找输血不良事件。我们还通过一项关于西班牙类似医院实践的调查来评估其情况。 结果共有 613 名患者在 2126 次输血中接受了 2260 种血液成分。总共 93% 的患者接受的输血次数少于 10 次。大多数患者因血液疾病（32%）或癌症（20%）接受治疗。不良反应发生率为2.68%，且随时间推移显着下降。发烧是最常见的不良反应。一天内输注一种以上血液制品的患者发生不良事件的风险较高。没有检测到任何错误或未遂事件，也没有患者因此而必须重新入院。对类似医院的 HT 实践的调查显示，实践中存在很大差异。 结论 当由专门的 HH 单位和训练有素的工作人员按照特定方案对选定的患者进行 HT 时，HT 是可行的、可持续的和安全的。
BACKGROUNDHospital at Home (HH) provides specialized care at the patients' homes. Keeping patients in familial surroundings can result in better outcomes reducing readmission to hospital, mortality, and costs of care. Home transfusion (HT) can be a key element in HH management but is scarcely deployed due to concerns about safety and cost. We have reviewed our HT practice to assess its feasibility and safety.STUDY DESIGN AND METHODSWe prospectively reviewed data collected from 1985 to 2015, focusing specially on feasibility and procedural safety, looking for adverse events of transfusion. We also assessed the situation in similar hospitals in Spain with a survey about their practice.RESULTSA total of 613 patients received 2260 blood components in 2126 transfusion episodes. A total of 93% patients received fewer than 10 transfusions. Most patients were treated for blood diseases (32%) or cancers (20%). The rate of adverse effects was 2.68% and decreased significantly with time. Fever was the most common adverse reaction. Patients who received transfusion of more than one blood product in a day were at higher risk of adverse events. No errors or near-miss events were detected, and no patient had to be readmitted to hospital for this cause. The survey on HT practices in similar hospitals showed great variation in practice.CONCLUSIONHT is feasible, sustainable, and safe, when performed on selected patients by dedicated HH units with well-trained staff, under specific protocols.