Transfusion practices in geriatric short stay unit before and after the French national health authority guidelines of 2014
| Autor: | Anne Laure Couderc, M. Pellerey, Vanessa Pauly, Aurélie Daumas, Patrick Villani, Christine Clapasson, N. Gobin, Stéphane Gayet, P. Lévêque, Pierre Caunes, Jacques Chiaroni, Barbara Mizzi |
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| Přispěvatelé: | Assistance Publique - Hôpitaux de Marseille (APHM), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Etablissement Français du Sang - Alpes-Méditerranée (EFS - Alpes-Méditerranée), Etablissement Français du Sang, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Anemia [SDV]Life Sciences [q-bio] Population Guidelines as Topic Hemoglobins medicine Humans guidelines education Short Stay Unit red blood cell transfusion Biological Psychiatry Retrospective Studies Aged 80 and over National health Geriatrics education.field_of_study geriatrics business.industry Length of Stay Reference Standards medicine.disease anemia 3. Good health Neuropsychology and Physiological Psychology Short stay Heart failure Charlson comorbidity index Emergency medicine Female France Neurology (clinical) Geriatrics and Gerontology Erythrocyte Transfusion business |
| Zdroj: | Gériatrie et Psychologie Neuropsychiatrie du Vieillissement Gériatrie et Psychologie Neuropsychiatrie du Vieillissement, John Libbey Eurotext, 2018, ⟨10.1684/pnv.2018.0759⟩ Gériatrie et psychologie & neuropsychiatrie du vieillissement Gériatrie et psychologie & neuropsychiatrie du vieillissement, 2018, ⟨10.1684/pnv.2018.0759⟩ |
| ISSN: | 2115-8789 2115-7863 |
| DOI: | 10.1684/pnv.2018.0759⟩ |
| Popis: | Anemia is the most common hematological pathology in geriatrics. Its prevalence increases with age. It is considered as a fragility factor because leading to loss of autonomy and other complications. Transfusion is a common practice in geriatrics. In 2014, the French national health authority guidelines recommended hemoglobin concentration rates for transfusion on the elderly over 80 years-old. The objective of this study is to compare transfusion practices in geriatric short-stay units, before and after these guidelines were edited. Methods Retrospective descriptive study in two geriatric short stay units, including patients aged 80 years-old or over, transfused in 2012 and 2015. Results 103 patients were included. More than 30% patients had a chronic heart failure, and there was no significant difference on general characteristics between the groups in the two years. Compared to 2012, the transfused population in 2015 was more fragile with a higher Charlson comorbidity index (p=0.005). The main symptoms of anemia bad tolerance were cardiovascular symptoms. The average pre-transfusion hemoglobin concentration was 7.9 g/dL in 2015, 8 g/dL in 2012 (p=0.63). By 2015, 72.3% transfusions respected the hemoglobin thresholds recommended in guidelines, compared to 50% in 2012 (p=0.023). Transfusion thresholds in our study were lower than those recommended; 13 adverse reactions were identified, 12 of them were heart failure. There was no significant difference in transfusion benefit between the two years. Conclusion This study helped describe profile of elderly transfused patients, their geriatric characteristics and the transfusion data, without showing any changes in transfusion practices following the guidelines, despite a more fragile population in 2015. It seems difficult, because of the diversity in the geriatric population, to have a single threshold of hemoglobin recommended, only non-specific symptoms of intolerance and to consider only the cardiovascular comorbidities to decide whether or not to provide a transfusion. |
| Databáze: | OpenAIRE |
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