Association between Adherence to Patient Blood Management Recommendations and Postoperative Complications in Hip and Knee Arthroplasty
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Garcia-Casanovas A.
- Bisbe E.
- Vizoso A.
- Sarsanedas E.
- Garcia-Altes A.
- Colomina M.J.
- Barquero M.
- Basora M.
- Ruiz Puig A.
- Rosas Ruiz A.
- Cuadrado Rodríguez Control De Gestión A.
- Aranguren Azparren A.
- Abad Gosálbez A.
- Morales A.
- Pedrero Gil A.
- Caballero A.
- Lavado À.
- Jericó C.
- Elena Sanabria Pico C.
- Martinez Escribano C.
- Mendez E.
- Vers Soto E.
- Cerezo Velasco E.
- Vall Atero E.
- Mas Ciurana E.
- Sancho Ponce E.
- Vila Ribas E.
- Bassas Parga E.
- Javier García-Miguel F.
- José Jimeno Demuth F.
- Moreno-Jimenez G.
- Gómez Montero G.
- Sanchez-Pedrosa G.
- Azparren Cabezón G.
- De La Fuente Graciani I.
- Fornet Ruiz I.
- Castrillo Martínez I.
- Enrique Ortega Lucas J.
- Gorricho J.
- Mata Estévez J.
- Vagace J.M.
- Colomina Morales J.
- Antonio García Erce J.
- Luis Campuzano Garcia J.
- Luis González-Rodríguez J.
- Maria García-Gala J.
- Regí Roman K.
- Francisca Ávila Idrovo L.
- Martínez Almirante L.
- González Del Castillo L.M.
- Pisano Blanco M.A.
- Romero Conejo M.
- Jesus Laso Morales M.
- Pilar Ruiz Dãíaz M.
- Raquel Díaz Comino M.
- Teresa Villán González M.
- Canales Navarro M.
- Albacar-Ingla M.
- Rey Mesa M.
- Cadena Serramitja M.
- Torra Riera M.
- Ibarra N.
- Gallench Pons N.
- Ruiz N.
- González Navarro P.
- Millacoy Austenrritt P.
- Marzal Sorolla P.
- Arribas P.
- Herranz Andrés P.
- Robles-Cedeño R.
- Tolós París R.
- Drudis R.
- Goterris R.
- Isabel Upegui R.
- Arbonés R.
- Valencia Castillo S.
- Aguilar Lopez S.
- Aragón Alvarez S.
- Marin Duran S.
- Planella T.
- Dueñas V.
- Estepa Calvo V.
- Robles Marinas V.
- Turcu Paraschiv V.
- Soler Abel X.
- Cabanillas Y.
- Palacios Gómez Y.
Grupos
Abstract
Background: Patient blood management (PBM) is a set of evidence-based practices that reduces the need for blood transfusions. However, its impact on relevant clinical outcomes remains unclear. The authors evaluated the association between adherence to guideline-recommended PBM care and 30-day postoperative complications in patients undergoing primary total knee and hip arthroplasty. Secondary outcomes included the length of hospital stay and erythrocyte utilization. Methods: This was a retrospective, multicenter cohort study including patients from 43 hospitals. The PBM clinical pathway comprised nine major guideline-recommended interventions, and adherence was assessed using a composite quality indicator. Multilevel multivariable regression models were used to evaluate the associations between PBM adherence and outcomes at the patient level while accounting for hospital characteristics and hospital variation. Results: A total of 30,926 patients who underwent primary total knee or hip arthroplasty between 2016 and 2022 at 43 hospitals were included. Of these, 1,335 (4.3%) had 30-day postoperative complications. The median adherence to the PBM clinical pathway was 60.0%. Higher PBM adherence was associated with fewer 30-day postoperative complications (adjusted odds ratio, 0.43; 95% CI, 0.32 to 0.58; P < 0.001), including 65% lower odds of major adverse cardiac events and 45% lower odds of infection. Additionally, higher adherence was associated with shorter hospital stays (adjusted incidence rate ratio, 0.77; 95% CI, 0.76 to 0.79; P < 0.001) and reduced transfusion rates (adjusted odds ratio, 0.11; 95% CI, 0.09 to 0.14; P < 0.001). Sensitivity analyses confirmed these associations. Conclusions: Adherence to the PBM clinical pathway was associated with improved outcomes. While causality cannot be established, these findings support the potential effectiveness of PBM in reducing postoperative complications and its efficiency in shortening hospital stays, beyond minimizing blood transfusions, in patients undergoing knee and hip arthroplasty. Copyright © 2025 American Society of Anesthesiologists. All Rights Reserved.
Datos de la publicación
- ISSN/ISSNe:
- 0003-3022, 1528-1175
- Tipo:
- Article
- Páginas:
- 24-37
- PubMed:
- 40085850
- Enlace a otro recurso:
- www.scopus.com
- Factor de Impacto:
- 1,648 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
ANESTHESIOLOGY LIPPINCOTT WILLIAMS & WILKINS
Documentos
- No hay documentos
Filiaciones
Keywords
- Aged; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Blood Transfusion; Cohort Studies; Female; Guideline Adherence; Humans; Length of Stay; Male; Middle Aged; Postoperative Complications; Retrospective Studies; antifibrinolytic agent; adult; aged; Article; clinical outcome; clinical pathway; cohort analysis; controlled study; erythrocyte transfusion; female; hospitalization; human; incidence; infection; length of stay; major adverse cardiac event; major clinical study; male; multicenter study; patient blood management; patient compliance; postoperative complication; retrospective study; risk factor; sensitivity analysis; surgical technique; total hip replacement; total knee arthroplasty; adverse event; blood transfusion; clinical trial; epidemiology; hip replacement; knee replacement; middle aged; postoperative complication; protocol compliance
Cita
Garcia A,Bisbe E,Vizoso A,Sarsanedas E,Garcia A,Colomina MJ,Barquero M,Basora M,Ruiz A,Rosas A,Cuadrado Rodríguez Control De Gestión A,Aranguren A,Abad A,Morales A,Pedrero A,Caballero A,Lavado À,Jericó C,Elena Sanabria Pico C,Martinez C,Mendez E,Vers E,Cerezo E,Vall E,Mas E,Sancho E,Vila E,Bassas E,Javier García F,José Jimeno Demuth F,Moreno G,Gómez G,Sanchez G,Azparren G,De La Fuente I,Fornet I,Castrillo I,Enrique Ortega Lucas J,Gorricho J,Mata J,Vagace JM,Colomina J,Antonio García Erce J,Luis Campuzano Garcia J,Luis González J,Maria García J,Regí K,Francisca Ávila Idrovo L,Martínez L,González Del Castillo LM,ISABEL CAMPOS PELÁEZ M,Pisano MA,Romero M,Jesus Laso Morales M,Pilar Ruiz Dãíaz M,Raquel Díaz Comino M,Teresa Villán González M,Canales M,Albacar M,Rey M,Cadena M,Torra M,Ibarra N,Gallench N,Ruiz N,González P,Millacoy P,Marzal P,Arribas P,Herranz P,SOLVES P,Robles R,Tolós R,Drudis R,Goterris R,Isabel R,Arbonés R,Valencia S,Aguilar S,Aragón S,Marin S,Planella T,Dueñas V,Estepa V,Robles V,Turcu V,Soler X,Cabanillas Y,Palacios Y. Association between Adherence to Patient Blood Management Recommendations and Postoperative Complications in Hip and Knee Arthroplasty. Anesthesiology. 2025. 143. (1):p. 24-37. IF:9,400. (1).
Portal de investigación