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Evaluation of Short-Term Effects on Colorectal Surgery Elective Patients after Implementing a Patient Blood Management Program: A Multicenter Retrospective Analysis.
Carannante, Filippo; Capolupo, Gabriella Teresa; Barberio, Manuel; Altamura, Amedeo; Miacci, Valentina; Scopigno, Martina Zenobia; Circhetta, Erika; Costa, Gianluca; Caricato, Marco; Viola, Massimo Giuseppe.
Afiliación
  • Carannante F; Colorectal Surgery Clinical and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, University Campus Bio-Medico, Via Àlvaro del Portillo 200, 00128 Rome, Italy.
  • Capolupo GT; Research Unit of Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy.
  • Barberio M; Colorectal Surgery Clinical and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, University Campus Bio-Medico, Via Àlvaro del Portillo 200, 00128 Rome, Italy.
  • Altamura A; Research Unit of Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy.
  • Miacci V; General Surgery Department, Ospedale Card. G. Panico, 73039 Tricase, Italy.
  • Scopigno MZ; General Surgery Department, Ospedale Card. G. Panico, 73039 Tricase, Italy.
  • Circhetta E; Colorectal Surgery Clinical and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, University Campus Bio-Medico, Via Àlvaro del Portillo 200, 00128 Rome, Italy.
  • Costa G; Research Unit of Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy.
  • Caricato M; Colorectal Surgery Clinical and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, University Campus Bio-Medico, Via Àlvaro del Portillo 200, 00128 Rome, Italy.
  • Viola MG; Haematology and Stem Cell Transplant Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Àlvaro del Portillo 200, 00128 Rome, Italy.
J Clin Med ; 13(15)2024 Jul 29.
Article en En | MEDLINE | ID: mdl-39124714
ABSTRACT

Introduction:

Patients who undergo surgery may require a blood transfusion and patients undergoing major colorectal surgery are more prone to preoperative and perioperative anemia. Blood transfusions have, however, long been associated with inflammatory and oncological complications. We aim to investigate the effects of an optimal implementation of a patient blood management (PBM) program in our hospital.

Methods:

This study retrospectively reviewed data from two different prospectively maintained databases of all patients undergoing elective major colorectal surgery with either a laparoscopic, open, or robotic approach from January 2017 to December 2022 at two different high-volume colorectal surgery Italian centers the Colorectal Surgery Unit of Fondazione Policlinico Campus Bio-Medico in Rome and the Colorectal Surgery Unit of Fondazione Cardinale Panico in Tricase (Lecce). Our study compares the first group, also known as pre-PBM (January 2017-December 2018) and the second group, known as post-PBM (January 2021-December 2022).

Results:

A total of 2495 patients, who satisfied the inclusion and exclusion criteria, were included in this study, with, respectively, 1197 patients in the pre-PBM group and 1298 in the post- PBM group. The surgical approach was similar amongst the two groups, while the operative time was longer in the pre-PBM group than in the post-PBM group (273.0 ± 87 vs. 215.0 ± 124 min; p < 0.001). There was no significant difference in preparatory Hb levels (p = 0.486), while anemia detection was significantly higher post-PBM (p = 0.007). However, the rate of transfusion was drastically reduced since the implementation of PBM, with p = 0.032 for preoperative, p = 0.025 for intraoperative, and p < 0.001 for postoperative.

Conclusions:

We confirmed the need to reduce blood transfusions and optimize transfusion procedures to improve short-term clinical outcomes of patients. The implementation of the PBM program was associated with a significant reduction in the rate of perioperative transfusions and an increase in only appropriate transfusions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza