Red cell transfusions in total knee and total hip replacement surgery.
Red cell transfusions in total knee and total hip replacement surgery.
复制标题
全膝关节和全髋关节置换手术中的红细胞输注。
DOI：
10.1046/j.1537-2995.1991.31691306252.x
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发表时间：
1991
期刊：
影响因子：
2.9
通讯作者：
Poss,R
中科院分区：
文献类型：
--
作者：
Surgenor,DM;Wallace,EL;Churchill,WH;Hao,SH;Chapman,RH;Poss,R
为了探索如何使用红细胞输注来支持接受诊断相关组（DRG）209（主要关节和肢体复位手术）中的初次和翻修髋关节和膝关节置换术的患者，我们研究了1986年美国151家医院的抽象患者出院记录。总共使用了9684单位的全血和/或分离的红细胞来支持6472名患者。输血的使用因外科手术而异，患者性别是一个影响因素。大部分患者在不需要输血的情况下接受手术。在输血患者中，大多数接受1至3个单位的红细胞;然而，少数患者需要多次输血，从而利用了不成比例的血液资源。比较七家最活跃的医院的输血实践，发现实际输血的患者百分比存在显著差异（p ≤ 0.01），但每个输血患者输注的红细胞成分的平均单位数无显著差异。当所有医院根据整形外科服务活动分为五类时，对输血实践进行比较也出现了类似的结果。全膝关节置换术和全髋关节置换术均观察到这些影响。可以得出结论，缺乏明确定义的输血标准导致了观察到的差异。
To explore how red cell transfusions were used to support patients who underwent primary and revision hip and knee replacements classified within diagnosis‐related group (DRG) 209 (major joint and limb reattachment procedures), we studied abstracted patient discharge records from 151 United States hospitals in 1986. A total of 9684 units of whole blood and/or separated red cells was used to support 6472 patients. The transfusion use varied by surgical procedure, with patient gender as an influencing factor. Large proportions of patients underwent surgery without requiring transfusion. Among transfused patients, the majority received 1 to 3 units of red cells; however, a minority of patients required multiple transfusions, thereby utilizing a disproportionate share of the blood resource. Comparison of transfusion practice within the seven most active hospitals revealed significant differences (p less than or equal to 0.01) in the percentage of patients actually transfused, but not in the mean number of units of red cell components transfused per transfused patient. Similar findings emerged from comparison of transfusion practice when all hospitals were segregated into five hospital classes on the basis of orthopedic surgical service activity. These effects were seen for both total knee and total hip replacement procedures. It can be concluded that the lack of clearly defined criteria for transfusion contributed to the variations observed.