Anemia management and transfusion strategy in internal medicine units: Less is more
Rattachement africain : it. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Blood transfusion is one of the most overused procedures, especially in elderly patients. Despite the current transfusion guidelines recommending a restrictive transfusion strategy in stable patients, the clinical practice varies according to physicians' experience and implementation of patient blood management. This study aimed to evaluate the anemia management and transfusion strategy in anemic elderly hospitalized and the impact of an educational program. We enrolled ≥ 65-year-old patients who presented or developed anemia during admission to a tertiary hospital's internal medicine and geriatric units. Patients with onco-hematological disorders, hemoglobinopathies and active bleeding were excluded. In the first phase, anemia management was monitored. In the second phase, the six participating units were divided into two groups and two arms: Educational (Edu) and non-educational (NE). During this phase, physicians in the Edu arm underwent an educational program for the appropriate use of transfusion and anemia management. In the third phase, anemia management was monitored. Comorbidities, demographic and hematological characteristics were similar in all phases and arms. The percentages of transfused patients during phase 1 were 27.7% in NE and 18.5% in the Edu arm. During phase 3, it decreased to 21.4% in the NE and 13.6% in the Edu arm. Hemoglobin levels at discharge and after 30 days were higher in the Edu group despite reduced use of blood transfusion. In conclusion, a more restrictive strategy was comparable or superior to the more liberal one in terms of clinical outcomes, with the advantage of saving red blood cell units and reducing related side effects.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Anemia management and transfusion strategy in internal medicine units: Less is more
- Date Crossref
- 01/09/2023
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Milan pays non établi dans la noticeUniversité ou école supérieure
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Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Immunology and Allergology Unit pays non établi dans la noticeÉtablissement de santé
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Università degli Studi di Milano pays non établi dans la noticeInstitution
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Biological Resource Center and Precision Medicine Lab Department of Transfusion Medicine and Hematology pays non établi dans la noticeStructure de recherche
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Department of Pathophysiology and Transplantation pays non établi dans la noticeInstitution
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Department of Clinical Sciences and Community Health pays non établi dans la noticeÉtablissement de santé
University of Milan, Immunology and Allergology Unit — Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico et Università degli Studi di Milano, avec 3 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.