BACKGROUND Obstetric patient blood management (PBM) strategies were used at Corniche Hospital in 2018, initially focusing on minimizing bleeding, with other clinical strategies implemented incrementally. This study assesses program outcomes in patients with major obstetric hemorrhage of 2000 mL or greater. METHODS A retrospective study of 353 women admitted to The Corniche Hospital between 2018 and 2023 who experienced major obstetric hemorrhage of 2000 mL or greater. The primary outcome measure was units of red blood cell (RBC), fresh-frozen plasma (FFP), and platelet units transfused. Secondary outcomes included pretransfusion hemoglobin in patients with no active bleeding, hemoglobin levels 3 weeks postdischarge, anemia predelivery, blood product-acquisition cost savings, mortality, composite morbidity (transfusion reaction, acute lung injury, thrombosis, sepsis, postpartum hysterectomy), hospital and high-dependency unit length of stay, and all-cause emergency readmissions within 28 days. RESULTS Comparing baseline (2018) with the final year (2023), the mean units of RBCs, FFP, and platelets transfused per admission decreased from 4.18 to 0.67 (P-trend <.001), resulting in blood acquisition savings of US$ 175,705. Over the same period the percentage of women anemic predelivery decreased from 40.3% to 23.8% (P-trend = 0.015) and the mean pretransfusion hemoglobin level in nonactively bleeding patients decreased from 7.54 g/dL to 6.35 g/dL (P-trend < .001). The mean hemoglobin rise 3 weeks postdischarge increased from 2.41 g/dL in 2018 to 4.26 g/dL in 2023. There were no changes in adjusted composite morbidity, hospital, or high-dependency unit length of stay. CONCLUSIONS In women with a major obstetric hemorrhage of 2000 mL or greater, the implementation of an obstetric PBM program was associated with reduced blood product utilization, reduced costs, reduced anemia, and increased hemoglobin rise postdischarge.

中文翻译：

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与重大产科出血患者血液管理计划相关的结果：一项回顾性队列研究。


背景 2018 年，Corniche 医院使用了产科患者血液管理 （PBM） 策略，最初侧重于减少出血，其他临床策略逐步实施。本研究评估了 2000 mL 或更大产科大出血患者的计划结果。方法 一项回顾性研究，对 2018 年至 2023 年间在 Corniche 医院收治的 353 名产科大出血女性进行回顾性研究，这些女性经历了 2000 mL 或更大的产科大出血。主要结局指标是输注的红细胞 （RBC） 、新鲜冰冻血浆 （FFP） 和血小板单位。次要结局包括无活动性出血患者的输血前血红蛋白、出院后 3 周的血红蛋白水平、分娩前贫血、血液制品获取成本节省、死亡率、复合发病率 （输血反应、急性肺损伤、血栓形成、败血症、产后子宫切除术）、住院和高依赖病房住院时间，以及 28 天内的全因紧急再入院。结果 将基线（2018 年）与最后一年（2023 年）进行比较，每次入院输注的红细胞、FFP 和血小板的平均单位从 4.18 下降到 0.67（P 趋势 <.001），从而节省 175,705 美元的采血费用。在同一时期，妇女分娩前贫血的百分比从 40.3% 下降到 23.8% （P 趋势 = 0.015），非活动性出血患者的平均输血前血红蛋白水平从 7.54 g/dL 下降到 6.35 g/dL （P 趋势 < .001）。出院后 3 周的平均血红蛋白升高从 2018 年的 2.41 g/dL 增加到 2023 年的 4.26 g/dL。调整后的复合发病率、住院时间或高依赖病房住院时间没有变化。 结论 在产科大出血 2000 mL 或以上的妇女中，产科 PBM 计划的实施与出院后血液制品利用率降低、成本降低、贫血减少和血红蛋白升高增加有关。