骨科手术患者术前贫血对围手术期输血与临床结局的影响

doi:10.3969/j.issn.1671-2587.2022.04.001

临床输血与检验 ›› 2022, Vol. 24 ›› Issue (4): 409-415.DOI: 10.3969/j.issn.1671-2587.2022.04.001

• 临床输血 • 下一篇

骨科手术患者术前贫血对围手术期输血与临床结局的影响

潘雪, 宋英伟, 林洁, 张晓娟, 张婷, 刘丽, 汪德清, 于洋

100853中国人民解放军总医院第一医学中心输血医学科

收稿日期:2022-03-18 出版日期:2022-08-20 发布日期:2022-08-19
通讯作者: 于洋,副主任医师,硕士研究生导师,主要从事临床输血学研究,（E-mail） yuyangpla301@163.com。
作者简介:潘雪（1990-）,女,主管技师,主要从事无偿献血者招募相关研究,（E-mail）415071913@qq.com。

Effects of Preoperative Anemia on Perioperative Blood Transfusion and Clinical Outcomes in Patients Undergoing Orthopedic Surgery

PAN Xue, SONG Ying-Wei, LIN Jie, et al

Department of Blood Transfusion, The First Medical Center, Chinese PLA General Hospital, Beijing 100853

Received:2022-03-18 Online:2022-08-20 Published:2022-08-19

摘要/Abstract

摘要： 目的调查骨科手术患者术前贫血对围手术期输血及临床结局的影响。方法选取2014年1月~2019年1月接受骨科手术的33 379名住院患者作为调查对象,采用倾向评分匹配法（propensityscore matching,PSM）将术前贫血作为独立因变量进行比较,分析骨科手术患者术前不同程度贫血对围手术期输血及临床结局的影响。结果 PSM后,术前轻度、中重度贫血患者住院天数延长（LOS≥; 12 d）者分别占34.5%、41.75%;围手术期红细胞输注率分别为58.24%、73.34%;ICU入住率分别为2.84%、4.97%;住院费用中位数分别为74 035.26元、74 589.56元,以上结果均显著高于非贫血患者（P<0.001）;术前轻度、中重度贫血患者并发症发病率5.18%、5.98%,均显著高于非贫血患者（P<0.05）。结论骨科手术患者术前贫血可导致其住院天数延长、围手术期输血率与输血量增高、ICU入住率与住院费用增加、术后并发症发生率增高。

关键词: 术前贫血, 输血, 倾向评分匹配, 骨科

Abstract: Objective In this article, we discussed the effect of preoperative anemia on perioperative blood transfusion and clinical outcomes in patients undergoing orthopedic surgery. Methods 33 379 hospitalized patients who underwent orthopedic surgery from January 2014 to January 2019 were selected as the survey subjects, and preoperative anemia was used as an independent variable to compare the effect of different degrees of anemia on perioperative blood transfusion and clinical outcomes by propensity score matching (PSM).Results After PSM, 34.5% of patients with mild anemia and 41.75% of patients with moderate to severe anemia had longer hospital stay (LOS≥12 d), and their perioperative red blood cell infusion rates were 58.24% and 73.34%, respectively. The ICU occupancy rates of the two groups were 2.84% and 4.97%, and the median hospitalzation expenses were ¥74 035.26 and ¥74 589.56 respectively, which were significantly higher than those of non-anemia group (P<0.001). The incidence of complications in patients with mild and moderate to severe anemia was 5.18% and 5.98%, respectively, which were significantly higher than those in non-anemia patients (P<0.05).Conclusions The preoperative anemia in patients undergoing orthopedic surgery could prolong their hospital stay, increase the perioperative blood transfusion rate and blood transfusion volume, and at the same time which could lead to a rise in ICU admission rate, hospitalization costs and postoperative complications.

Key words: Preoperative anemia, Blood transfusion, PSM, Orthopedics

中图分类号:

R457

潘雪, 宋英伟, 林洁, 张晓娟, 张婷, 刘丽, 汪德清, 于洋. 骨科手术患者术前贫血对围手术期输血与临床结局的影响[J]. 临床输血与检验, 2022, 24(4): 409-415.

PAN Xue, SONG Ying-Wei, LIN Jie, et al. Effects of Preoperative Anemia on Perioperative Blood Transfusion and Clinical Outcomes in Patients Undergoing Orthopedic Surgery[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2022, 24(4): 409-415.

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骨科手术患者术前贫血对围手术期输血与临床结局的影响

Effects of Preoperative Anemia on Perioperative Blood Transfusion and Clinical Outcomes in Patients Undergoing Orthopedic Surgery

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