A Patient Blood Management Program in Prosthetic Joint Arthroplasty Decreases Blood Use and Improves Outcomes

• Published in: The Journal of arthroplasty Vol. 31; no. 1; pp. 11 - 14
• Main Authors: Loftus, Terrence J., MD, MBA, FACS, Spratling, Larry, MD, Stone, Barbara A., RN, MSN, MHA, CNOR, Xiao, Liang, MS, Jacofsky, David J., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2016
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - statistics & numerical data; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - statistics & numerical data; Blood Loss, Surgical; blood transfusion; Blood Transfusion - statistics & numerical data; Blood Transfusion, Autologous; Cohort Studies; Female; hip arthroplasty; Humans; knee arthroplasty; Male; Middle Aged; Orthopedics; outcomes; patient blood management; Retrospective Studies; tranexamic acid; blood transfusion; knee arthroplasty; hip arthroplasty; patient blood management; outcomes; tranexamic acid
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2015.07.040

Abstract The objective of this study was to determine if a Patient Blood Management (PBM) program implemented for patients undergoing THA or TKA would result in a decrease in the percentage of patients transfused PRBCs and improve outcomes. Decision support, a key driver for this program, was built into the electronic medical record. This retrospective cohort study included 12,590 patients and demonstrated a 44% decrease in the percentage of patients transfused. This was associated with a significant reduction in complications, 30 day readmissions and HLOS. A PBM program for patients undergoing prosthetic joint arthroplasty for primary and revision total hip and knee arthroplasty results in fewer transfusions and is associated with improved outcomes.