PREPARE

作者：Sigismond Lasocki, Rüdiger Krauspe, Christian von Heymann, Anna Mezzacasa, Suki Chainey, Donat Rudolf Spahn · 发表于：European Journal of Anaesthesiology · 年份：2015 · DOI：10.1097/eja.0000000000000202 · 被引用次数：208 · 研究领域：Blood transfusion and management、Erythropoietin and Anemia Treatment、Iron Metabolism and Disorders

BACKGROUND: Patient blood management (PBM) can prevent preoperative anaemia, but little is known about practice in Europe. OBJECTIVE: To assess the pre and postoperative prevalence and perioperative management of anaemia in patients undergoing elective orthopaedic surgery in Europe. DESIGN: An observational study; data were collected from patient records via electronic case report forms. SETTING: Seventeen centres in six European countries. Centres were stratified according to whether they had a PBM programme or not. PATIENTS: One thousand five hundred and thirty-four patients undergoing major elective hip, knee or spine surgery [49.9% hip, 37.2% knee, 13.0% spine; age 64.0 years (range 18 to 80), 61.3% female]. MAIN OUTCOME MEASURES: Prevalence of preoperative (primary endpoint) and postoperative anaemia [haemoglobin (Hb) <13 g dl (male), Hb <12 g dl (female)], perioperative anaemia management, time to first blood transfusion and number of transfused units. Data are shown as mean (SD) or median (interquartile range). RESULTS: Anaemia prevalence increased from 14.1% preoperatively to 85.8% postoperatively. Mean Hb decrease was 1.9 (1.5) and 3.0 (1.3) g dl in preoperatively anaemic and nonanaemic patients, respectively (P < 0.001). In PBM (n = 7) vs. non-PBM centres, preoperative anaemia was less frequent (8.0 vs. 18.5%; P < 0.001) and iron status was assessed more frequently (ferritin 11.0 vs. 2.6%, transferrin saturation 11.0 vs. 0.1%; P < 0.001). Perioperative anaemia corre...