Impact of a Patient Blood Management Program and an Outpatient Anemia Management Protocol on Red Cell Transfusions in Oncology Inpatients and Outpatients

摘要: BACKGROUND Patient blood management (PBM) programs are associated with reduced transfusion usage, hospital costs, and improved patient outcomes. The application of PBM principles in patients malignant disease might achieve similar results. However, this population presents unique challenges. aim the present study was to investigate impact a program on usage outcomes cancer patients, particularly setting restricted use erythropoiesis-stimulating agents (ESAs). MATERIALS AND METHODS A retrospective observational performed admitted primary diagnosis malignancy treated at Eastern Maine Medical Center as inpatients or outpatients, both, from January 2008 through July 2013. RESULTS proportion outpatients receiving ESAs decreased 2.9% 1.1% 2013 (p < .001). During same period, an increase occurred mean dose intravenous (IV) iron 447 mg (95% confidence interval [CI], 337-556) 588 CI, 458-718). red cell (RBC) units transfused per inpatient outpatient episode 0.067 0.038 unit In inpatients, significant increases single-unit RBC transfusions .001) infused IV = .02), decreases pretransfusion hemoglobin .02) rate .04). In-hospital mortality length stay did not change significantly during period. CONCLUSION Despite ESA therapy, implementation anemia protocol our medical center reductions usage.