예정 수술에서의 수술 별 적혈구제제 최대혈액신청량 재설정 = An Update of Maximum Surgical Blood Order Schedule in Elective Surgery

다국어 초록 (Multilingual Abstract)

Background: Recently, operation technology and health care environment are continuously improving and changing. An updated MSBOS using current blood usage data is necessary for efficient blood management in the hospital blood bank.
Methods: This study was a retrospective analysis based on operation names according to the ICD-9-CM at Severance hospital in 2013. We calculated the average units of red blood cells according to each operation, as well as the total units of RBCs used per each operation and patient. Finally an average unit of RBCs was set for the MSBOS, which were ordered before surgical operation. These analyzed results were compared with the previous reports of our hospital and other hospitals.
Results: Transfusion episodes occurred in 3,092 cases, which is only 8.6% of all patients. Total transfused units were 8,230 units, 27% of total RBCs (2,270 units) transfused were used in cardiovascular surgery. Compared with the previous data, the usage of RBCs during surgery was decreased.
Conclusion: The MSBOS investigated in this study showed some differences in the indicators in 2007. Therefore, regular update of the MSBOS is necessary in each hospital to reflect the advancement of surgical technology.

국문 초록 (Abstract)

배경: 발전하는 수술기법과 변화하는 의료환경에 맞는 혈액제제 의뢰지침을 설정하기 위해최근 1년 간 세브란스병원에서 진행된 수술 시 혈액사용량을 조사하여 최대혈액신청량(MSBOS)를재설정하고자 하였다.
방법: 2013년에 세브란스병원에서 시행 된 수술을 ICD-9-CM 기준에 따라 분류하여 조사하였다. 수술 시 환자가 받은 적혈구 제제의 수혈량의평균값을 적용하여 최대혈액신청량을 설정하였다. 분석된 결과를 동일 병원의 과거 결과 및 국내 타 병원의 결과와 비교하였다.
결과: 총 수술 중, 적혈구제제를 환자에게 수혈한 비율은 8.6% (3,092/35,885)이었다. 수술 시 사용한 적혈구제제는 총 8,230단위였다. 심장혈관수술에서 2,270단위로 가장 많은 적혈구제제가사용되었다. 평균 수혈량이 높은 수술은 흉부외과로 수술 환자당 평균 4.27단위의 적혈구제제를수혈하였다. 과거에 비해 수술 시 사용된 적혈구제제는 감소하였다.
결론: 본 연구에서 조사한 최대혈액신청량은2007년 지표와 일부 차이를 보였다. 최대혈액신청량은 병원마다의 특성이나, 각 시기에 따라 변동하므로, 각 병원은 일정 시기마다 최대혈액신청량을 개정할 필요성이 있겠다.

참고문헌 (Reference)

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