The aim of this study is to describe the transfusion practices in patients undergoing major surgery in Turkey. The transfusion rates of red blood cells (RBC), fresh frozen plasma (FFP) and platelets; the transfusion predictors and transfusion related patient outcomes are investigated.
Patient Blood Management (PBM) is an evidence based multidisciplinary approach for the care of patients who may need blood transfusion. The aim of PBM is achieving better patient outcomes by focusing on the patients' own blood as a source. To date PBM is considered "good transfusion practice" and is being implemented in a growing number of countries. The Turkish Society of Anesthesiologists PBM Task Force is working on this subject since 4 years and decided to conduct a study. Before starting a PBM program, the transfusion practices of clinicians working at diverse surgical fields; differences between current transfusion practices and PBM strategies; the areas for improvement and the obstacles that could prevent change could be identified with this study. Data collection will also serve to identify the current situation as a reference and to control the achievement of the PBM's aim: improving clinical outcomes. These data will be refered as The Turkish National Perioperative Transfusion Study (TULIP TS) data. The aim of this study is to describe the transfusion practices in patients undergoing major surgery in Turkey. The study evaluates i. The perioperative transfusion rates of RBCs, FFP and platelets. ii. With which reasons the anesthesiologists decide to transfuse a patient (co morbidities of the patients, physiologic transfusion triggers, hemoglobin trigger, uncontrolled bleeding, on request from surgeon etc.). iii. The relation of transfusion and the patients co-morbidity index, the P POSSUM score and SORT score; anesthesia methods; monitorisation methods (hemodynamic, coagulation); amount of bleeding; type of surgery; type of hospital. iv. The relation of transfusion and patient outcomes (unanticipated ICU admission, prolonged ICU stay, acute renal failure, thromboembolic events, ischemic events, pulmonary complications, cardiac advers events, infections, acute respiratory distress, infection, all-cause mortality).
Study Type
OBSERVATIONAL
Enrollment
6,481
Transfusion of blood products in the perioperative period in patients undergoing major surgery
Preoperative amount of blood products transfused
Preoperative amount of blood products: RBCs,FFP and platelets transfused
Time frame: Before surgery at day 0
Intraoperative amount of blood products transfused
Intraoperative amount of blood products: RBC's,FFP and platelets transfused
Time frame: During surgery at day 0
Postoperative amount of blood products transfused
Postoperative amount of blood products: RBCs,FFP and platelets transfused
Time frame: 24 hours after surgery
Preoperative transfusion indications
The reasons to decide to transfuse (factors determining transfusion) blood products
Time frame: Before surgery at day 0
Intraoperative transfusion indications
The reasons to decide to transfuse (factors determining transfusion) blood products
Time frame: During surgery at day 1
Postoperative transfusion indications
The reasons to decide to transfuse (factors determining transfusion) blood products
Time frame: 24 hours after surgery
Unanticipated ICU admission
Whether the patient had an unanticipated ICU admission
Time frame: After surgery at day 1
Prolonged length of stay in ICU
Whether the patient had a prolonged length of stay in ICU
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Time frame: After surgery at day 2
Acute renal failure
Whether the patient had acute renal failure
Time frame: After surgery at day 2
Thromboembolic event
Whether the patient had a thromboembolic event concerning lungs (pulmonary embolism), brain (stroke), gastrointestinal tract, kidneys, or extremities etc.
Time frame: After surgery at day 2
Ischemic event
Whether the patient had an ischemic event concerning heart, nervous system,limb, gastrointestinal tract etc.
Time frame: After surgery at day 2
Infection
Whether the patient had infection: wound, pneumonia, urinary, sepsis etc.
Time frame: After surgery at day 2
Acute respiratory distress
Whether the patient had acute respiratory distress
Time frame: After surgery at day 2
Mortality
Whether the patient died: all cause mortality
Time frame: after surgery at day 30
Preoperative anemia
Whether the patient had anemia (Hemoglobin male \< 13 female \< 12 g/dL)
Time frame: Before surgery at day 0
Preoperative coagulopathy
Whether the patient had coagulopathy due to disease or drugs
Time frame: Before surgery at day 0
Pretransfusion hemoglobin values
The hemoglobin concentration before transfusion
Time frame: Before surgery at day 0
Pretransfusion hemoglobin values
The hemoglobin concentration before transfusion
Time frame: During surgery at day 1
Pretransfusion hemoglobin values
The hemoglobin concentration before transfusion
Time frame: After surgery at day 2
Advers cardiac events
Whether the patient had an advers cardiac event: myocardial infaction; non fatal cardiac arest; arrhytmia; cardiogenic pulmonary edema etc
Time frame: After surgery at day 30