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Volume 12 Issue 3
May  2021
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TANG Bo, XU Xiaohan, ZHANG Yuelun, HUANG Yuguang. A Longitudinal Study of Perioperative Allogeneic Red Blood Cell Transfusion among Patients Undergoing Thoracotomy for Lobectomy in China[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(3): 333-338. DOI: 10.12290/xhyxzz.2021-0140
Citation: TANG Bo, XU Xiaohan, ZHANG Yuelun, HUANG Yuguang. A Longitudinal Study of Perioperative Allogeneic Red Blood Cell Transfusion among Patients Undergoing Thoracotomy for Lobectomy in China[J]. Medical Journal of Peking Union Medical College Hospital, 2021, 12(3): 333-338. DOI: 10.12290/xhyxzz.2021-0140
shu

A Longitudinal Study of Perioperative Allogeneic Red Blood Cell Transfusion among Patients Undergoing Thoracotomy for Lobectomy in China

  • 1.

    Department of Anesthesiology, , Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 2.

    Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds: 

CAMS Innovation Fund for Medical Sciences(CIFMS) 2016-I2M-3-024

More Information
  • Corresponding author:

    ZHANG Yuelun Tel: 86-10-69152020, E-mail:yuelunzhang@outlook.com

    HUANG Yuguang Tel: 86-10-69155591, E-mail:garypumch@163.com

  • Received Date: January 31, 2021
  • Accepted Date: February 22, 2021
  • Available Online: April 20, 2021
  • Issue Publish Date: May 29, 2021
    Graphical Abstract
    • Abstract
  •   Objective  Restrictive transfusion strategy is recommended in "Perioperative Transfusion Guidelines (2014, China)" to limit the use of allogeneic red blood cell (RBC) transfusion. We aimed to examine whether the transfusion practice had changed.
      Methods  This study was a longitudinal population-based study. Using the database of Hospital Quality Monitoring System (HQMS), patients undergoing thoracotomy for lobectomy with or without lymph node dissection in tertiary hospitals between January 1st, 2013 and August 31st, 2018 in Mainland China were included. The main outcome was allogeneic RBC transfusion. The year- and area-specific crude prevalence and the age/sex-adjusted prevalence of allogeneic RBC transfusion with 95% confidence intervals (CI) were estimated using mixed-effects Logistic regression models.
      Results  A total of 93 285 patients were included, and 4367 (4.68%, 95% CI: 4.55%-4.82%) patients received allogeneic RBC transfusion. The yearly crude prevalence of RBC transfusion from 2013 to 2018 were 6.89% (95% CI: 6.52%-7.29%), 5.23% (95% CI: 4.93%-5.55%), 4.15% (95% CI: 3.88%-4.44%), 4.32% (95% CI: 4.03%-4.62%), 3.73% (95% CI: 3.45%-4.03%), and 4.37% (95% CI: 3.49%-5.46%), respectively. After adjusting to age, sex and area, a decline in the prevalence of allogeneic RBC transfusion was observed over time. The prevalence was lowest and below the average level in 2017 (aOR=0.82, 95% CI: 0.68-1.00) while rose a bit in 2018 (aOR=1.12, 95% CI: 0.85-1.48). Geographically, the prevalence of allogeneic RBC transfusion showed wide variability. At the regional level, the prevalence was highest in Northwest China (aOR=2.74, 95% CI: 2.19-3.42) and lowest in Eastern China (aOR=0.23, 95% CI: 0.19-0.29).
      Conclusion  From 2013 to 2018, a decrease in the proportion of patients exposed to allogeneic RBC transfusion in perioperative care of thoracotomy for lobectomy was observed after the implementation of restrictive transfusion strategy in China. Extensive geographic variability in the prevalence of perioperative transfusion existed among patients.
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    • References (24)
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