Peri-operative blood transfusion in elective major surgery: incidence, indications and outcome - an observational multicentre study.

Autor:	Unal D; Department of Anaesthesiology and Reanimation, University of Health Sciences Diskapi Yildirim Beyazit Teaching Hospital, Ankara, Turkey., Senayli Y; Department of Anaesthesiology and Reanimation, 'Ankara Gulhane' Teaching Hospital, Ankara, Turkey., Polat R; Department of Anaesthesiology and Reanimation, University of Health Sciences Diskapi Yildirim Beyazit Teaching Hospital, Ankara, Turkey., Spahn DR; Institute of Anaesthesiology, University of Zurich and University Hospital Zurich, Zurich, Switzerland., Toraman F; Department of Anaesthesiology, 'Acibadem Mehmet Ali Aydınlar' University School of Medicine, Istanbul, Turkey., Alkis N; Department of Anaesthesiology and Reanimation, Ankara University Medical Faculty, Ankara, Turkey., Zekeriyya A; Department of Anaesthesiology and Reanimation, Ankara University Medical Faculty, Ankara, Turkey., Bahar A; Department of Anaesthesiology and Reanimation, Mersin City Hospital, Mersin, Turkey., Onat BA; Department of Anaesthesiology and Reanimation, Ankara University Medical Faculty, Ankara, Turkey., Hulya B; Department of Anaesthesiology and Reanimation, Bursa Uludag University Medical Faculty, Bursa, Turkey., Mehmet B; Department of Anaesthesiology, Istanbul University Medical Faculty, Istanbul, Turkey., Nesil C; Department of Anaesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey., Asli D; Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara City Hospital, Ankara, Turkey., Suna G; Department of Anaesthesiology and Reanimation, Bursa Uludag University Medical Faculty, Bursa, Turkey., Meltem GC; Department of Anaesthesiology and Reanimation, Acibadem Mehmet Ali Aydınlar University School of Medicine, Atakent Hospital, Istanbul, Turkey., Mukadder O; Department of Anaesthesiology, Istanbul University Medical Faculty, Istanbul, Turkey., Mert S; Department of Anaesthesiology, Istanbul University Medical Faculty, Istanbul, Turkey., Busra T; Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara City Hospital, Ankara, Turkey., Ilksen TH; Department of Anaesthesiology, Inonu University Liver Transplantation Institute, Malatya, Turkey., Cigdem YG; Department of Anaesthesiology and Reanimation, Ankara University Medical Faculty, Ankara, Turkey., Suheyla A; Department of Anaesthesiology and Reanimation, University of Health Sciences Fatih Sultan Mehmet Teaching Hospital, Istanbul, Turkey., Yesim A; Department of Anaesthesiology and Reanimation, University of Health Sciences Istanbul Teaching Hospital, Istanbul, Turkey., Arzu AE; Department of Anaesthesiology and Reanimation, Hitit University, School of Medicine, Corum Erol Olcok Teaching Hospital, Corum, Turkey., Esra AT; Department of Anaesthesiology and Reanimation, University of Health Sciences Okmeydanı Teaching Hospital, Istanbul, Turkey., Ali A; Department of Anaesthesiology and Reanimation, Karadeniz Technical University Medical Faculty Farabi Hospital, Trabzon, Turkey., Mine A; Department of Anaesthesiology, University of Health Sciences Ankara Child Health and Diseases Hematology Oncology Teaching Hospital, Ankara, Turkey., Nukhet A; Department of Anaesthesiology and Reanimation, Baskent University Medical Faculty Ankara Hospital, Ankara, Turkey., Mustafa AS; Department of Anaesthesiology and Reanimation, Ankara Ataturk Teaching Hospital, Ankara, Turkey., Ergin A; Department of Anaesthesiology and Reanimation, University of Health Sciences Izmir Tepecik Teaching Hospital, Izmir, Turkey., Cavidan AM; Department of Anaesthesiology and Reanimation, Namık Kemal University Medical Faculty, Tekirdag, Turkey., Sule A; Department of Anaesthesiology and Reanimation, Necmettin Erbakan University Meram Medical Faculty, Konya, Turkey., Gulbin AA; Department of Anaesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey., Emine A; Department of Anaesthesiology and Reanimation, University of Health Sciences Diskapi Yildirim Beyazit Teaching Hospital, Ankara, Turkey., Esma A; Department of Anaesthesiology and Reanimation, Gazi University Medical Faculty, Ankara, Turkey., Mahmut A; Department of Anaesthesiology and Reanimation, Sutcu Imam University Medical Faculty, Kahramanmaraş, Turkey., Necmiye A; Department of Anaesthesiology and Reanimation, University of Health Sciences Kanuni Sultan Suleyman Teaching Hospital, Istanbul, Turkey., Zuhal A; Department of Anaesthesiology and Reanimation, Marmara University Pendik Teaching Hospital, Istanbul, Turkey., Hilal A; Department of Anaesthesiology and Reanimation, Zonguldak Bulent Ecevit University Medical Faculty Center for Health and Research, Zonguldak, Turkey., Cumhur B; Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara Teaching Hospital, Ankara, Turkey., Volkan B; Department of Anaesthesiology and Reanimation, Ankara University Medical Faculty, Ankara, Turkey., Nurdan B; Department of Anaesthesiology and Reanimation, Gazi University Medical Faculty, Ankara, Turkey., Azize B; Department of Anaesthesiology and Reanimation, Fırat University Medical Faculty, Elazıg, Turkey., Zekiye B; Department of Anaesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey., Ugur BM; Department of Anaesthesiology and Reanimation, University of Health Sciences Izmir Bozyaka Teaching Hospital, Izmir, Turkey., Faruk BO; Department of Anaesthesiology and Reanimation, Sutcu Imam University Medical Faculty, Kahramanmaraş, Turkey., Sibel B; Department of Anaesthesiology and Reanimation, Dokuz Eylul University Medical Faculty, Izmir, Turkey., Sanem CT; Department of Anaesthesiology and Reanimation, Ankara University Medical Faculty, Ankara, Turkey., Meltem C; Department of Anaesthesiology and Reanimation, University of Health Sciences Izmir Tepecik Teaching Hospital, Izmir, Turkey., Baris C; Department of Anaesthesiology and Reanimation, Marmara University Pendik Teaching Hospital, Istanbul, Turkey., Ayse C; Department of Anaesthesiology and Reanimation, University of Health Sciences Kayseri Teaching Hospital, Kayseri, Turkey., Zubeyir C; Department of Anaesthesiology and Reanimation, Ordu University Medical Faculty, Ordu, Turkey., Banu CEF; Department of Anaesthesiology and Reanimation, Yenimahalle Teaching Hospital, Ankara, Turkey., Faruk C; Department of Anaesthesiology and Reanimation, Selcuk University Medical Faculty, Konya, Turkey., Alkin C; Department of Anaesthesiology and Reanimation, Trakya University Medical Faculty, Edirne, Turkey., Ziya CY; Department of Anaesthesiology, Inonu University Liver Transplantation Institute, Malatya, Turkey., Esra D; Department of Anaesthesiology and Reanimation, University of Health Sciences Okmeydanı Teaching Hospital, Istanbul, Turkey., Fisun DH; Department of Anaesthesiology and Reanimation, Balikesir University Medical Faculty Teaching Hospital, Balıkesir, Turkey., Abdurrahim D; Department of Anaesthesiology and Reanimation, University of Health Sciences Kanuni Sultan Suleyman Teaching Hospital, Istanbul, Turkey., Ayca DO; Department of Anaesthesiology and Reanimation, Ankara Ataturk Teaching Hospital, Ankara, Turkey., Osman E; Department of Anaesthesiology and Reanimation, University of Health Sciences Haydarpasa Numune Teaching Hospital, Istanbul, Turkey., Gulay EK; Department of Anaesthesiology and Reanimation, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey., Engin E; Department of Anaesthesiology and Reanimation, Karadeniz Technical University Medical Faculty Farabi Hospital, Trabzon, Turkey., Ipek E; Department of Anaesthesiology and Reanimation, University of Health Sciences Umraniye Teaching Hospital, Istanbul, Turkey., Tekeli AE; Department of Anaesthesiology and Reanimation, Van Yuzuncu yil University Medical Faculty Dursun Odabası Medical Center, Van, Turkey., Mehmet G; Department of Anaesthesiology and Reanimation, University of Health Sciences Yuksek Ihtisas Teaching Hospital, Bursa, Turkey., Basak G; Department of Anaesthesiology and Reanimation, University of Health Sciences Diskapi Yildirim Beyazit Teaching Hospital, Ankara, Turkey., Gamze G; Department of Anaesthesiology and Reanimation, Tunceli State Hospital, Tunceli, Turkey., Emel G; Department of Anaesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey., Isin G; Department of Anaesthesiology and Reanimation, Erciyes University, Medical Faculty, Kayseri, Turkey., Betul GA; Department of Anaesthesiology, University of Health Sciences Etlik Zubeyde Hanim Gynecology and Obstetrics Teaching Hospital, Ankara, Turkey., Gulcin H; Department of Anaesthesiology and Reanimation, Necmettin Erbakan University Meram Medical Faculty, Konya, Turkey., Nazan HS; Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara Numune Teaching Hospital, Ankara, Turkey., Ozgen IK; Department of Anaesthesiology and Reanimation, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Atakent Hospital, Istanbul, Turkey., Ayse IE; Department of Anaesthesiology and Reanimation, University of Health Sciences Konya Teaching Hospital, Konya, Turkey., Muzeyyen I; Department of Anaesthesiology and Reanimation, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Atakent Hospital, Istanbul, Turkey., Inci K; Department of Anaesthesiology and Reanimation, Selcuk University Medical Faculty, Konya, Turkey., Deniz K; Department of Anaesthesiology and Reanimation, Ondokuz Mayis University Medical Faculty, Samsun, Turkey., Derya K; Department of Anaesthesiology and Reanimation, University of Health Sciences Yuksek Ihtisas Teaching Hospital, Bursa, Turkey., Arzu K; Department of Anaesthesiology and Reanimation, University of Health Sciences Antalya Teaching Hospital, Antalya, Turkey., Duygu KA; Department of Anaesthesiology and Reanimation, University of Health Sciences Umraniye Teaching Hospital, Istanbul, Turkey., Mensure K; Department of Anaesthesiology and Reanimation, University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Teaching Hospital, Ankara, Turkey., Suleyman K; Department of Anaesthesiology and Reanimation, Ankara Ataturk Teaching Hospital, Ankara, Turkey., Zuleyha KB; Department of Anaesthesiology and Reanimation, Ufuk University School of Medicine, Ankara, Turkey., Gulsen K; Department of Anaesthesiology, University of Health Sciences Ankara Child Health and Diseases Hematology Oncology Teaching Hospital, Ankara, Turkey., Oya K; Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara Numune Teaching Hospital, Ankara, Turkey., Yeliz K; Department of Anaesthesiology and Reanimation, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey., Pakize K; Department of Anaesthesiology and Reanimation, Suleyman Demirel University Medical Faculty, Isparta, Turkey., Zeynep K; Department of Anaesthesiology and Reanimation, University of Health Sciences Kayseri Teaching Hospital, Kayseri, Turkey., Ceren K; Department of Anaesthesiology and Reanimation, University of Health Sciences Fatih Sultan Mehmet Teaching Hospital, Istanbul, Turkey., Betul K; Department of Anaesthesiology and Reanimation, University of Health Sciences Konya Teaching Hospital, Konya, Turkey., Semih K; Department of Anaesthesiology and Reanimation, Dokuz Eylul University Medical Faculty, Izmir, Turkey., Gamze K; Department of Anaesthesiology and Reanimation, Zonguldak Bulent Ecevit University Medical Faculty Center for Health and Research, Zonguldak, Turkey., Ilke K; Department of Anaesthesiology and Reanimation, Ministry of Health Erzincan University Mengucek Gazi Teaching Hospital, Erzincan, Turkey., Aysun K; Department of Anaesthesiology and Reanimation, University of Health Sciences Kecioren Teaching Hospital, Ankara, Turkey., Omer K; Department of Anaesthesiology and Reanimation, Gazi University Medical Faculty, Ankara, Turkey., Ceyda MB; Department of Anaesthesiology and Reanimation, Ankara University Medical Faculty, Ankara, Turkey., Burak N; Department of Anaesthesiology and Reanimation, University of Health Sciences Diskapi Yildirim Beyazit Teaching Hospital, Ankara, Turkey., Dilek OR; Department of Anaesthesiology and Reanimation, Zonguldak Bulent Ecevit University Medical Faculty Center for Health and Research, Zonguldak, Turkey., Dilek O; Department of Anaesthesiology and Reanimation, Dokuz Eylul University Medical Faculty, Izmir, Turkey., Yavuz O; Department of Anaesthesiology and Reanimation, Sutcu Imam University Medical Faculty, Kahramanmaraş, Turkey., Elif O; Department of Anaesthesiology and Reanimation, University of Health Sciences Haydarpasa Numune Teaching Hospital, Istanbul, Turkey., Esra Ö; Department of Anaesthesiology and Reanimation, University of Health Sciences Kecioren Teaching Hospital, Ankara, Turkey., Menekse O; Department of Anaesthesiology and Reanimation, Ankara University Medical Faculty, Ankara, Turkey., Sabri OE; Department of Anaesthesiology and Reanimation, Suleyman Demirel University Medical Faculty, Isparta, Turkey., Yetkin O; Department of Anaesthesiology and Reanimation, Anadolu Health Center, Istanbul, Turkey., Aysegul O; Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara City Hospital, Ankara, Turkey., Ozgur OM; Department of Anaesthesiology and Reanimation, Private Cankaya Hospital, Ankara, Turkey., Onur O; Department of Anaesthesiology, University of Economics and Technology, Medical Faculty Hospital, Ankara, Turkey., Ozlem S; Department of Anaesthesiology and Reanimation, Balikesir University Medical Faculty Teaching Hospital, Balıkesir, Turkey., Arzu S; Department of Anaesthesiology and Reanimation, University of Health Sciences Kayseri Teaching Hospital, Kayseri, Turkey., Aslinur S; Department of Anaesthesiology and Reanimation, Mersin University Medical Faculty, Mersin, Turkey., Mehmet S; Department of Anaesthesiology and Reanimation, University of Health Sciences Kecioren Teaching Hospital, Ankara, Turkey., Cihan S; Department of Anaesthesiology, University of Economics and Technology, Medical Faculty Hospital, Ankara, Turkey., Yeliz S; Department of Anaesthesiology and Reanimation, Hitit University, School of Medicine, Corum Erol Olcok Teaching Hospital, Corum, Turkey., Nevriye S; Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara City Hospital, Ankara, Turkey., Ayten S; Department of Anaesthesiology and Reanimation, Marmara University Pendik Teaching Hospital, Istanbul, Turkey., Tolga SK; Department of Anaesthesiology and Reanimation, University of Health Sciences Kartal Dr. Lutfi Kirdar Teaching Hospital, Istanbul, Turkey., Hilal S; Department of Anaesthesiology and Reanimation, University of Health Sciences Derince Teaching Hospital, Kocaeli, Turkey., Gokce SS; Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara City Hospital, Ankara, Turkey., Betul S; Department of Anaesthesiology and Reanimation, Istanbul Medeniyet University Goztepe Teaching Hospital, Istanbul, Turkey., Ozlem S; Department of Anaesthesiology and Reanimation, University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Teaching Hospital, Ankara, Turkey., Bengi SE; Department of Anaesthesiology and Reanimation, Ondokuz Mayis University Medical Faculty, Samsun, Turkey., Isil SF; Department of Anaesthesiology and Reanimation, University of Health Sciences Antalya Teaching Hospital, Antalya, Turkey., Emin S; Department of Anaesthesiology and Reanimation, University of Health Sciences Kayseri Teaching Hospital, Kayseri, Turkey., Dilek SF; Department of Anaesthesiology and Reanimation, University of Health Sciences Haydarpasa Numune Teaching Hospital, Istanbul, Turkey., Ebru TK; Department of Anaesthesiology and Reanimation, University of Health Sciences Umraniye Teaching Hospital, Istanbul, Turkey., Nilay T; Department of Anaesthesiology and Reanimation, Ordu University Medical Faculty, Ordu, Turkey., Tuncel TZ; Department of Anaesthesiology and Reanimation, University of Health Sciences Izmir Bozyaka Teaching Hospital, Izmir, Turkey., Sibel T; Department of Child Health and Diseases, University of Health Sciences Kecioren Teaching Hospital, Ankara, Turkey., Gonul TK; Department of Anaesthesiology and Reanimation, Manisa Celal Bayar University Medical Faculty Hafsa Sultan Hospital, Manisa, Turkey., Hulya T; Department of Anaesthesiology and Reanimation, Hitit University, School of Medicine, Corum Erol Olcok Teaching Hospital, Corum, Turkey., Abdurrahman T; Department of Anaesthesiology and Reanimation, University of Health Sciences Istanbul Teaching Hospital, Istanbul, Turkey., Fatih U; Department of Anaesthesiology and Reanimation, Balikesir University Medical Faculty Teaching Hospital, Balıkesir, Turkey., Canan U; Department of Anaesthesiology and Reanimation, University of Health Sciences Ankara Numune Teaching Hospital, Ankara, Turkey., Petek U; Department of Anaesthesiology and Reanimation, University of Health Sciences Haydarpasa Numune Teaching Hospital, Istanbul, Turkey., Suheyla U; Department of Anaesthesiology and Reanimation, University of Health Sciences Dr Abdurrahman Yurtaslan Ankara Oncology Teaching Hospital, Ankara, Turkey., Gulcin US; Department of Anaesthesiology and Reanimation, Osmaniye State Hospital, Osmaniye, Turkey., Filiz U; Department of Anaesthesiology and Reanimation, Hacettepe University School of Medicine, Ankara, Turkey., Selcan YA; Department of Anaesthesiology and Reanimation, Bursa Uludag University Medical Faculty, Bursa, Turkey., Kadir Y; Department of Anaesthesiology and Reanimation, University of Health Sciences Okmeydanı Teaching Hospital, Istanbul, Turkey., Mustafa Y; Department of Anaesthesiology and Reanimation, University of Health Sciences Diskapi Yildirim Beyazit Teaching Hospital, Ankara, Turkey., Aysun YA; Department of Anaesthesiology and Reanimation, Fırat University Medical Faculty, Elazıg, Turkey., Munise Y; Department of Anaesthesiology and Reanimation, University of Health Sciences Konya Teaching Hospital, Konya, Turkey., Hatice YE; Department of Anaesthesiology and Reanimation, University of Health Sciences Izmir Tepecik Teaching Hospital, Izmir, Turkey., Hakan Y; Department of Anaesthesiology and Reanimation, Ufuk University School of Medicine, Ankara, Turkey., Mehmet Y; Department of Anaesthesiology and Reanimation, University of Health Sciences Derince Teaching Hospital, Kocaeli, Turkey., Nureddin Y; Department of Anaesthesiology and Reanimation, Van Yuzuncu Yil University Medical Faculty Dursun Odabası Medical Center, Van, Turkey.
Jazyk:	angličtina
Zdroj:	Blood transfusion = Trasfusione del sangue [Blood Transfus] 2020 Jul; Vol. 18 (4), pp. 261-279.
DOI:	10.2450/2020.0011-20
Abstrakt:	Background: Patients' demographic and epidemiological characteristics, local variations in clinicians' knowledge and experience and types of surgery can influence peri-operative transfusion practices. Sharing data on transfusion practices and recipients may improve patients' care and implementation of Patient Blood Management (PBM). Materials and Methods: This was a multicentre, prospective, observational, cross-sectional study that included 61 centres. Clinical and transfusion data of patients undergoing major elective surgery were collected; transfusion predictors and patients' outcomes were analysed. Results: Of 6,121 patients, 1,579 (25.8%) received a peri-operative transfusion. A total of 5,812 blood components were transfused: red blood cells (RBC), fresh-frozen plasma and platelets in 1,425 (23.3%), 762 (12.4%) and 88 (1.4%) cases, respectively). Pre-operative anaemia was identified in 2,019 (33%) patients. Half of the RBC units were used by patients in the age group 45-69 years. Specific procedures with the highest RBC use were coronary artery bypass grafting (16.9% of all units) and hip arthroplasty (14.9%). Low haemoglobin concentration was the most common indication for intra-operative RBC transfusion (57%) and plasma and platelet transfusions were mostly initiated for acute bleeding (61.3% and 61.1%, respectively). The RBC transfusion rate in study centres varied from 2% to 72%. RBC transfusion was inappropriate in 99% (n=150/151) of pre-operative, 23% (n=211/926) of intra-operative and 43% (n=308/716) of post-operative RBC transfusion episodes. Pre-operative haemoglobin, increased blood loss, open surgery and duration of surgery were the main independent predictors of intra-operative RBC transfusion. Low pre-operative haemoglobin concentration was independently associated with post-operative pulmonary complications. Conclusions: These findings identified areas for improvement in peri-operative transfusion practice and PBM implementation in Turkey.
Databáze:	MEDLINE
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