The Implementation of Patient Blood Management in a Tertiary Hospital: a 9-Year Retrospective Study of Blood Transfusion Practice.

Abstract

To analyze the changes in clinical transfusion practice and explore the exact benefits after the implementation of patient blood management (PBM). The retrospective study included transfusion practice data from West China Hospital of Sichuan University during the years 2009 - 2018. The data of surgical patients in 2010 were taken as the baseline (pre-PBM), and the data of surgical patients from 2012 to 2018 (post-PBM) were compared with the baseline. Outcome measures were the change in transfusion practice, patient outcomes, and economic benefits pre/post-PBM. Compared with pre-PBM, the rapid growth of clinical red blood cell (RBC) consumption was curbed, the total units of red blood cells (RBCs) transfused was 65,322 units pre-PBM and was 51,880.5 units in 2011. The transfusion rate per 1,000 surgical patients post-PBM was lower, and the mean units of intraoperative transfusion and surgery transfusion represented a 50% reduction. According to the product-acquisition cost, PBM had saved 46.58 million Renminbi (RMB) in 2012 - 2018. The proportion of ambulatory surgery and interventional surgery increased, the proportion of Hb transfusion trigger was significantly lower than that in 2010, and the average length of stay (ALOS) was improved. Properly implementing a PBM program had the potential to reduce unnecessary transfusions and the related risks and costs.