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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2022 April;181(4):239-42

DOI: 10.23736/S0393-3660.20.04476-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: Italian

Patient blood management in hip replacement: a virtuous public-private partnership

Francesca POLESE 1, Despina MANIA 2, Nevia ARREGHINI 1, Giovanni MAZZAROL 2, Renzo MALATESTA 3, Gianluca GESSONI 1, 4

1 Unit of Transfusion Medicine, ULSS 3 Serenissima, Mestre, Venice, Italy; 2 Unit of Orthopedics, Casa di Cura Policlinico San Marco, Mestre, Venice, Italy; 3 Casa di Cura Policlinico San Marco, Mestre, Venice, Italy; 4 Provincial Department of Transfusion Medicine, Venice, Italy



BACKGROUND: In the province of Venice (Italy), 2234 hip replacement operations (DRG 544) had been performed in 2015, 834 of these patients were transfused with a consumption of 2207 concentrates red blood cells units (RBC). Therefore, it was decided to activate a patient blood management (PBM) program which also involved the orthopedics of the Policlinico San Marco (PSM) (Mestre, Venice, Italy) which carries out about 30% of this type of intervention in the provincial context.
METHODS: A shared protocol was drawn up to promptly identify and correct pre-operative anemia, the PSM has identified a reference internist for the management of martial therapy and the most complex cases are sent for advice to the Transfusion Medicine (TM) of Mestre, Venice, Italy.
RESULTS: Against a substantially unchanged volume of activity, the number of transfusion requests has gone from 782 in 2015 to 332 in 2019 with a consumption of RBC that has gone from 324 to 64.
CONCLUSIONS: This experience seemed worthy of mention as it represents a moment of synergy between Public and Private which has led to a better clinical management of the patient through a multispecialist integration, to a continuous osmosis between the professionals operating in the two structures, to a reduction of RBC consumption and workload for operators.


KEY WORDS: Arthroplasty; Hip; Blood transfusion

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