[Risk analysis of postoperative anemia through biological databases querying].
BACKGROUND
The assessment of postoperative care relies mainly on spontaneous reporting of major adverse events (MAE). We propose an alternative approach that we have tested on the measurement of the risk of postoperative anemia which is frequentely associated with anaesthethic related deaths.


METHODS
The procedure consisted in extracting the electronic sheet generated by the biological analyser and merging it with the anesthesia data base with a filter based on patient's location in the hospital. The orthopedic surgery ward was chosen because of the frequency of full blood count (FBC) associated with the prescription of low weight molecular heparin in this setting. All FBC of the year 2005 were analysed. A risk stratification was achieved according to the conbination of age and depth of anemia. Medical charts of patients exposed to the greatest risk were reviewed.


RESULTS
FBC of 691 orthopaedic surgery patients were analysed. Haemoglobin levels (Hb) less than 8g/dl were observed in 41 (5.9%) patients. Two consecutive Hb less than 8g/dl were founded in 18 patients (2.6%), eight (1.2%) charts of patients exposed to the highest risk were reviewed and six cases of no-transfusion or delayed transfusion were identified.


CONCLUSIONS
A global approach to the risk of postoperative anemia but also of MAE related to postoperative haemorrage can be obtained by monitoring electronic databases.
Service d'anesthésie-réanimation, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France. sylvain.ausset@gmail.com
S
S
Ausset
N
N
Donat
V
V
Foisseau
A
A
Cirodde
B
B
Clavier
Y
Y
Auroy
D000740:Anemia / Q000097:blood / Q000453:epidemiology*; D000925:Anticoagulants / Q000627:therapeutic use; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D004581:Electronics; D006454:Hemoglobins / Q000378:metabolism; D006470:Hemorrhage / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006757:Hospital Units; D006801:Humans; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000097:blood*; D018570:Risk Assessment
D000925:Anticoagulants; D006454:Hemoglobins; D006495:Heparin, Low-Molecular-Weight
Méthode d'analyse du risque d'exposition à l'anémie postopératoire par interrogation des bases de données de biologie.