Total Red Blood Cell Transfusions for Chronic Hemodialysis Patients in a Single Center, 2009-2013
| Autor: | James R. Stubbs, David Dingli, Craig L. Hocum, Amy W. Williams, James T. McCarthy, Robert C. Albright, John J. Dillon, La Tonya J. Hickson, Pamela M. Johnson |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Anemia education 030232 urology & nephrology MEDLINE Single Center End stage renal disease 03 medical and health sciences Hemoglobins 0302 clinical medicine Renal Dialysis hemic and lymphatic diseases Internal medicine medicine Humans Chronic hemodialysis 030212 general & internal medicine skin and connective tissue diseases Intensive care medicine health care economics and organizations business.industry medicine.disease Anemia management Red blood cell medicine.anatomical_structure sense organs Prospective payment system business Erythrocyte Transfusion |
| Zdroj: | Nephron. 133(1) |
| ISSN: | 2235-3186 |
| Popis: | Background: Anemia management in chronic hemodialysis (HD) has been affected by the implementation of the prospective payment system (PPS) and changes in clinical guidelines. These factors could impact red blood cell (RBC) transfusion in HD patients. Our distinctive care system contains complete records for all RBC transfusions among our HD patients. Aims: To determine RBC transfusions in patients with prevalent chronic HD, site of administration (inpatient or outpatient), and ordering physician specialty for inpatients; compare pre- and post-PPS RBC transfusions; and compare RBC transfusions during changes in desired outpatient hemoglobin (Hb) range for patients with chronic HD. Methods: Retrospective analysis of medical and blood bank records for patients with prevalent chronic HD July 2009 through June 2013. Results: In total, 310-356 patients were studied. Mean (SD) units of RBCs per 100 patients per month for the study's 48 months were outpatient, 2.6 (1.5), and inpatient, 9.4 (4.6). Outpatient pre-PPS RBC units transfused were 2.1 (0.6) vs. post-PPS of 2.6 (1.5; p = 0.22, t test); for inpatients pre-PPS, 7.9 (4.5) RBC units per month vs. post-PPS, 11.5 (5.1; p = 0.11, t test). Inpatient RBC transfusions accounted for 75.2% (14.2%) of all RBC transfusions; 67.3% (16.3%) of inpatient transfusions were ordered by nonnephrologists. Changes in desired Hb range for outpatient HD patients did not lead to changes in RBC transfusions. Conclusions: No changes in RBC transfusions occurred among our patients with chronic HD with PPS implementation and in desired Hb range during the study period. Most transfusions were given in inpatient settings by nonnephrologists. |
| Databáze: | OpenAIRE |
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