The effect of a preoperative erythropoietin protocol as part of a multifaceted blood management program in daily clinical practice (CME)

摘要: Background: The effectiveness of a preoperative erythropoietin (EPO) protocol to reduce allogeneic blood transfusions (ABTs) in daily clinical practice has been insufficiently studied. This study evaluated the effect such protocol, as part multifaceted management program, patients undergoing total hip arthroplasty (THA). Study Design and Methods: retrospective observational was designed an interrupted time series (1999-2010). intervention introduction EPO THA 2003. Patients were classified according hemoglobin (Hb) level: 10 13g/dL (eligible for EPO) more than 13g/dL. primary outcome percentage receiving ABT. Segmented regression analysis used estimate changes after intervention. Results: A 4568 included. absolute reductions ABTs 17% (95% confidence interval [CI], 6%-29%) population 25% CI, 11%-39%) 8% -5% 21%) Hb groups 13 13g/dL, respectively. In postintervention period, 46% eligible (Hb level, 10-13g/dL) actually received EPO. transfusion rate group lower compared non-EPO group: 14 50%, respectively (p Conclusion: Introduction reduced practice. reduction must be seen which increased awareness contributes simultaneously substantially rate.