Patient blood management and blood conservation – Complimentary concepts and solutions for blood establishments and clinical services in South Africa and beyond

Rambiritch, Vanitha; Verburgh, Estelle; Louw, Vernon

doi:10.1016/j.transci.2021.103207

Cited by 6 publications

(4 citation statements)

References 40 publications

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“…This disparity may be attributed to the variations in hospital standards and practices regarding transfusions, such as the criteria used to determine when a transfusion is necessary [ 6 ]. The group of no charge or self-pay might be unaffordable insurance, lower economic levels and poor health conditions (dietary iron deficiency, hemoglobinopathy, nutritional deficiencies, malaria and HIV/AIDS), which increase the need for blood transfusions [ 23 ]. Patients with comorbidities(≥1 of comorbidities) are more likely to require blood transfusions, especially elderly patients with other diseases.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for perioperative blood transfusion in patients undergoing total laparoscopic hysterectomy

Cao,

Liu,

Zhang

et al. 2024

BMC Women's Health

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Purpose The goal is to identify risk factors associated with receiving a blood transfusion during the perioperative period in patients who undergo total laparoscopic hysterectomy (TLH) using a large-scale national database. Methods In this retrospective analysis, data from the Nationwide Inpatient Sample (NIS) was utilized to review the medical records of all patients who underwent TLH from 2010 to 2019. The researchers identified patients who had received a blood transfusion during the perioperative period and compared with those who had not. The subsequent factors associated with blood transfusion were examined: hospital characteristics (type of admission and payer, patient demographics (age and race), bed size, teaching status, location, and region of hospital), length of stay (LOS), total charges during hospitalization, in-hospital mortality, comorbidities, and perioperative complications. The data was analyzed using descriptive statistics. The independent risk factors of perioperative blood transfusion after TLH was identified by performing multivariate logistic regression. Results A total of 79,933 TLH were captured from the NIS database, among which 3433 (4.40%) patients received a perioperative blood transfusion. TLH patients affected by blood transfusion were 2 days longer hospital stays (P < 0.001), higher overall costs (P < 0.001), the patients who received a transfusion after a long-term hospitalization had a significantly higher rate of mortality (0.5% vs. 0.1%; P < 0.001). Perioperative blood transfusion after TLH was associated with chronic blood loss anemia, deficiency anemia, coagulopathy, congestive heart failure, fluid and electrolyte disorders, renal failure, metastatic cancer, sepsis, weight loss, deep vein thrombosis, gastrointestinal hemorrhage, shock, acute myocardial infarction, and pneumonia, stroke, hemorrhage, pulmonary embolism, and disease of the genitourinary system. Conclusion Studying the risk factors of perioperative blood transfusion after TLH is advantageous in order to ensure proper management and optimize outcomes.

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Section: Discussionmentioning

confidence: 99%

Risk factors for perioperative blood transfusion in patients undergoing total laparoscopic hysterectomy

Cao,

Liu,

Zhang

et al. 2024

BMC Women's Health

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“…The Patient Blood Management (PBM) standard represents the integrated use of appropriate transfusion practices, multidisciplinary collaboration, preoperative diagnosis of anemia and appropriate clinical decision-making using evidence-based guidelines [1,2]. Anemia as a risk factor appears in about 29% of surgical patients.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of the Conditions and Barriers in Implementing the Patient Blood Management Standard by Anesthesiologists and Surgeons

Kazamer,

Ilinca,

Stanescu-Spinu

et al. 2024

Healthcare

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Patient Blood Management (PBM) as a multidisciplinary practice and a standard of care for the anemic surgical patient is playing an increasingly important role in reducing transfusions and optimizing both clinical outcomes and costs. The success of PBM implementation depends on staff awareness and involvement in this approach. The main objective of our study was to explore physicians’ perceptions of the conditions for implementing PBM in hospitals and the main obstacles they face in detecting and treating anemic patients undergoing elective surgery. This cross-sectional descriptive study includes 113 Romanian health units, representing 23% of health units with surgical wards nationwide. A 12-item questionnaire was distributed to the participants in electronic format. A total of 413 questionnaires representing the perceptions of 347 surgeons and 66 anesthesia and intensive-care specialists were analyzed. Although a lack of human resources was indicated by 23.70% of respondents as the main reason for not adhering the guidelines, the receptiveness of medical staff to implementing the PBM standard was almost 90%. In order to increase adherence to the standard, additional involvement of anesthesia and intensive-care physicians would be necessary from the perception of 35.70% of the responders: 23.60% of surgeons and 18.40% of hematologists.

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“…Transfusions carry numerous risks including increasing length of hospital stay, morbidity and mortality 4 . Authors have advised that low‐ and middle‐income countries (LMIC) establish systems to encourage the appropriate and consistent use of blood products according to evidence‐based principles 5 …”

Section: Introductionmentioning

confidence: 99%

“…4 Authors have advised that low-and middle-income countries (LMIC) establish systems to encourage the appropriate and consistent use of blood products according to evidence-based principles. 5 In South Africa, blood products are supplied by the South African National Blood Service (SANBS) and the Western Cape Blood Service, which require 3500 donations a day to maintain an adequate national supply. The country has a heavy burden of trauma, HIV, chronic medical conditions and a rapidly growing population.…”

mentioning

confidence: 99%

Analysis of a 5‐year, evidenced‐based, rational blood utilisation project in a South African regional hospital

Wise,

Hood,

Bishop

et al. 2023

Transfusion Medicine

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BackgroundBlood products are a lifesaving but limited resource, particularly in resource‐limited settings. Evidence‐based transfusion criteria tailored to local hospitals have shown great promise in reducing costs, minimising shortages, and ameliorating the morbidity and mortality associated with liberal blood product usage. We implemented the “Saving Blood, Saving Lives” project to: promote responsible blood product use and reduce blood product ordering inefficiencies and expenditure.MethodsA comprehensive change management programme, preceded by 3 months of clinical department consultation and training, was implemented. A new evidence‐based protocol for blood product utilisation was developed, together with an accountability form. This form was used in monthly audit meetings to refine policies, identify new problems, improve communication, and to drive hospital staff accountability and training. The primary measure of the programme's success was the change in the number of red cell concentrate units ordered.ResultsProject implementation required minimal time and no additional budget or staff. Annual red cell concentrate usage reduced from 7211 units in year one to 4077 units in year 5 (p < 0.001). Similar reductions were seen in freeze‐dried plasma and platelet usage, as well as administrative costs. Total project saving, adjusted to baseline admission numbers, amounted to over R46 million ($2.5 million).ConclusionsAs a change management programme centred the “Saving Blood, Saving Lives” project, was able to significantly reduce blood product‐related administration and expenditure by implementing evidence‐based transfusion criteria. The programme is simple, replicable and cost effective, making it ideally suited for use in resource‐constrained environments.

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Patient blood management and blood conservation – Complimentary concepts and solutions for blood establishments and clinical services in South Africa and beyond

Cited by 6 publications

References 40 publications

Risk factors for perioperative blood transfusion in patients undergoing total laparoscopic hysterectomy

Risk factors for perioperative blood transfusion in patients undergoing total laparoscopic hysterectomy

Perceptions of the Conditions and Barriers in Implementing the Patient Blood Management Standard by Anesthesiologists and Surgeons

Analysis of a 5‐year, evidenced‐based, rational blood utilisation project in a South African regional hospital

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