Transfusion requirement and length of stay of anaemic surgical patients associated with a patient blood management service:a single-Centre retrospective study

Objective To assess the value of patient blood management (PBM) in the detection and management of preoperative anaemia before elective surgery. Background PBM is recognised as the standard of care, with diagnosis and management of preoperative anaemia being the key components of PBM. No formal assessment of the value of PBM anaemia screening and correction before scheduled surgery had been made at our hospital. Methods We conducted a retrospective study in a tertiary-care, academic hospital of consecutive records of elective surgery (n = 25 641). We excluded minor surgeries. We identified anaemic patients who had been assessed by PBM or not (non-PBM). We calculated transfusion incidence and hospital length of stay (LOS) across all surgical specialities. Results During the 1-year study period, 15 245 patients were eligible for inclusion; 311 patients (2 center dot 0%) were transfused, and 83 center dot 3% of transfusions were in anaemic patients. Transfusion incidence was 9 center dot 2% in anaemic PBM-assessed patients and 17 center dot 4% in non-PBM patients. For haemoglobin (Hb) <100 g L-1, the transfusion incidence was 22 center dot 1% [95% confidence interval (CI) 15 center dot 5-30 center dot 6%] in PBM and 40 center dot 0% (95% CI 35 center dot 1-45 center dot 0%) in non-PBM patients, and for Hb 100-119 g L-1, it was 4 center dot 7% (95% CI 2 center dot 8-7 center dot 5%) and 7 center dot 9% (95% CI 6 center dot 3-9 center dot 8%), respectively. Overall mean LOS was 2 center dot 1 days [standard deviation (SD) 6 center dot 0]. Mean LOS with Hb <100 g L-1 was 6 center dot 7 days (SD 14 center dot 8) in PBM-assessed patients and 12 center dot 4 days (SD 19 center dot 5) in non-PBM patients and was 3 center dot 1 (SD 5 center dot 2) and 6 center dot 2 (SD 9 center dot 5) days, respectively, for Hb 100-119 g L-1. Conclusion Anaemic elective surgery patients assessed by patient blood management (PBM) had a markedly lower transfusion risk and shorter LOS than anaemic patients not assessed by PBM.