Effectiveness of a Multidisciplinary Quality Improvement Initiative on Peri-operative Morbidity using Patient Blood Management strategies in a Resource-Constrained Setting - 30/05/26
, Archana Bajpayee 2, Puneeth Babu Anne 3, Vasanth Asirvatham 4, Arun M 5, Vinay Bodanapu 4, Rajat Bansal 6, Alok Kumar Sharma 7, Marthati Aakarsh 8Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder
Keywords: Patient Blood Management, Quality Improvement, Perioperative Morbidity
Highlights |
• | The multidisciplinary quality improvement initiative at a tertiary care center in India demonstrated that systematic Patient Blood Management (PBM) significantly improves surgical outcomes in Lower-middle income countries using low-cost measures. |
• | Here are the core highlights of the study: |
• | Transfusion rates dropped from 24.9% to 14.5% after PBM. |
• | Post-operative hospital stay length was reduced by 51%. |
• | ICU admission frequency decreased by 41.6% relative risk. |
• | Iron supplementation adoption increased from 14.5% to 25.2%. |
• | Higher preoperative hemoglobin correlated with shorter stays. |
Abstract |
Introduction: Patient Blood Management (PBM) optimises patient outcomes by managing blood reserves and minimising transfusion needs. While its benefits are known, implementing PBM systematically is challenging, especially in resource-limited settings of low- and middle-income countries (LMIC). This study assesses the effectiveness of PBM strategies in clinical outcomes of perioperative patients undergoing elective surgery at a tertiary care hospital in Western Rajasthan, India. Methods: This two-phase prospective quality improvement study was conducted on patients undergoing elective surgery. Data were collected prospectively before and after PBM implementation from patient records, focusing on current practices including patient characteristics, pre-operative hemoglobin levels, allogeneic blood transfusions, length of hospital stay, and requirements for ICU stay. Results: Among the 938 patients included in the study, implementation of PBM strategies resulted in an increase in pre-operative hemoglobin levels from 11.94 to 12.3 g/dl (p=0 .011), hemoglobin at hospital discharge from 10.14 to 10.62 g/dl (p<0.001) and a reduction in transfusion rates from 24.9% to 14.5% (p<0.001). The overall length of hospital stays decreased by approximately 48%, and there was a reduction in ICU admissions (21.6% to 12.6%) and duration of ICU stay (p<0.006). Conclusion: Implementation of PBM improved patient outcomes, reduced transfusion needs, and optimised resource utilisation. The study emphasises the link between pre-operative hemoglobin levels and length of stay, stressing the importance of managing anemia for better clinical results. These results underscore the value of multidisciplinary collaboration, education, and standardised protocols in achieving PBM objectives.
Le texte complet de cet article est disponible en PDF.Keywords : Patient Blood Management, Hemoglobin optimization, Quality Improvement Study, Peri-operative morbidity
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