Blood management program reduces transfusions, improves outcomes for orthopedic patients

Editor's Note

A blood management program at Johns Hopkins using a hemoglobin transfusion threshold of 7 g/dl in orthopedic surgical patients reduced blood use by 32.5% and resulted in similar or improved outcomes. Improved outcomes were primarily in patients 65 years of age or older.

For this study, researchers evaluated 1,507 patients before and 2,402 patients after implementing a blood management program.

Among the findings:

• patients who received blood transfusions decreased from 16.1% to 9.4%
• average hemoglobin threshold used to trigger a transfusion decreased from 7.8 g/dl to 6.8 g/dl
• hospital-acquired complications fell from 1.3% to 0.54%
• 30-day readmissions decreased from 9% to 5.8%.

This is the first study to show a hemoglobin level of 7g/dl appears to be safe in most orthopedic patients, even elderly patients, the authors say.