Bir Üniversite Hastanesinin Cerrahi Kliniğinde Çalışan Doktorların Hasta Kan Yönetimine Yönelik Tutumları: Ankete Dayalı Bir Çalışma

Abstract

Objective: Our aim is to evaluate the attitudes of the doctors working in the surgical clinics of a university hospital on Patient Blood Management (PBM). Methods: This cross-sectional study was conducted in Zonguldak Bülent Ecevit University, Faculty of Medicine between December 2019 and January 2020, after obtaining ethical permission. The survey data were obtained by handing out the survey forms which consist of 33 questions to the doctors working in the hospital’s surgical clinics to fill out. The questions include demographic data, and attitudes on PBM. Results: Fully completed 91 surveys were evaluated. Of the participants, 81% were research assistants and 30% were anesthesiologists. The 61.5% of participants had PBM knowledge, 91% of them knew the relationship between preoperative anemia (POA) and preoperative morbidity, and mortality, and 54% were found to treat POA regularly. The 85% of the participants stated that anemia should be treated before elective surgery, and for this purpose, they transfused erythrocyte suspension (RBC) (67.5%) immediately before surgery. Apart from the hemoglobin (Hb) value, the most commonly used parameter in the RBC transfusion decision was the amount of bleeding >1000 mL. While it was found that the most common practice to reduce intra-operative blood transfusion was the diagnosis and correction of POA (85%), only 27.5% of the participants reported that it is necessary to act restrictively to ensure normothermia and for the Hb threshold value in the decision of transfusion. When participants were asked ‘how should they be treated if they are an anemic patient without cardiopulmonary disease and bleeding’, 69% of them said they ‘want their anemia to be recognized and treated before elective surgery'. Only 22% of the participants were aware that there was no written protocol on PBM in their institution. Conclusion: Study findings suggest that the adoption of PBM guidelines should be encouraged, more momentum should be given to implementing these programs, and other studies in this area are needed. Keywords: Patient blood management, perioperative anemia management, perioperative care