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Retrospective analysis of community hospital red blood cell recovery procedures: improved utilization needed for effectiveness.

Publication ,  Journal Article
Bellone, M; Pham, HP; Shaz, BH; Shi, PA
Published in: Transfusion
August 2015

BACKGROUND: Perioperative blood recovery (PBR) is an important component of patient blood management. We analyzed our experience providing PBR for community hospitals to determine procedure types and clinical variables associated with efficacy and cost-effectiveness. STUDY DESIGN AND METHODS: PBR cases (>25,000) from January 2008 through December 2012 were analyzed. For each procedure type, the median number of returned red blood cell units (rRBCs) and ratio of cases with at least 1 to less than 1 rRBC unit were calculated. Clinical predictors of rRBC were identified by linear and logistic regression. RESULTS: The overall median rRBC was 0.29 units despite median estimated blood loss (EBL) of 350 mL. Only three of 31 common procedure types had ≥1:<1 rRBC ratios near to or higher than 1. In nine of 31 common procedure types, at least 50% of cases had no rRBC return. Linear regression demonstrated significant association of rRBCs with increased EBL, longer operative duration, surgeon, PBR device type (autoLog vs. CS5), and decreasing age. EBL, autoLog use, high surgeon case volume, vascular procedures, and emergent versus elective procedures associated with higher odds of at least 1 rRBC. CONCLUSION: Discrepancy between rRBC and EBL and high percentages of cases with no rRBC suggests that PBR technique and case selection need optimization. Identification of procedure types and variables associated with PBR efficacy (≥1 rRBC) should improve utilization of PBR. Association of autoLog use with higher rRBC warrants further investigation.

Duke Scholars

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

August 2015

Volume

55

Issue

8

Start / End Page

1972 / 1979

Location

United States

Related Subject Headings

  • Surgical Procedures, Operative
  • Specialties, Surgical
  • Retrospective Studies
  • Operative Blood Salvage
  • New York City
  • Humans
  • Hospitals, Urban
  • Hospitals, Community
  • Hospital Bed Capacity
  • Erythrocyte Transfusion
 

Citation

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Bellone, M., Pham, H. P., Shaz, B. H., & Shi, P. A. (2015). Retrospective analysis of community hospital red blood cell recovery procedures: improved utilization needed for effectiveness. Transfusion, 55(8), 1972–1979. https://doi.org/10.1111/trf.13062
Bellone, Michael, Huy P. Pham, Beth H. Shaz, and Patricia A. Shi. “Retrospective analysis of community hospital red blood cell recovery procedures: improved utilization needed for effectiveness.Transfusion 55, no. 8 (August 2015): 1972–79. https://doi.org/10.1111/trf.13062.
Bellone, Michael, et al. “Retrospective analysis of community hospital red blood cell recovery procedures: improved utilization needed for effectiveness.Transfusion, vol. 55, no. 8, Aug. 2015, pp. 1972–79. Pubmed, doi:10.1111/trf.13062.
Journal cover image

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

August 2015

Volume

55

Issue

8

Start / End Page

1972 / 1979

Location

United States

Related Subject Headings

  • Surgical Procedures, Operative
  • Specialties, Surgical
  • Retrospective Studies
  • Operative Blood Salvage
  • New York City
  • Humans
  • Hospitals, Urban
  • Hospitals, Community
  • Hospital Bed Capacity
  • Erythrocyte Transfusion