title: Red cell transfusion in orthopaedic surgery: a benchmark study performed combining data from different data sources.
abstract: BACKGROUND
  Previous studies have shown the usefulness of combining information from different data sources to identify and analyse variations in transfusion practices. Good knowledge of the conditions leading to blood use is a fundamental requirement for the assessment of the appropriateness of blood transfusion.
  
  
  METHODS
  In this study we combined blood transfusion data obtained from the Blood Bank information system with patients' data from the Hospital Discharge Database, based on the ICD9 classification system, from 1,827 surgical procedures performed in seven different orthopaedic divisions in the Ravenna area between January and December 2009. Hip and knee replacement surgery (primary or revision) and operations following femoral fractures (partial hip replacement and reduction with internal fixation) were considered. For a subgroup of patients clinical and transfusion data were also combined with haemoglobin values obtained from the laboratory information system.
  
  
  RESULTS
  Of the 1,827 surgical procedures, 1,038 (56.8%) were followed by transfusion of red cells. The likelihood of receiving a transfusion varied depending on the patient's sex (49% for males, 60% for females), age, and on the surgical procedure, being higher for interventions following femoral fractures and for revisions of hip replacement: about 70% of patients undergoing these interventions required transfusion. A large variability in transfusion rates was observed between the seven divisions, which was only partially explained by the different types of surgery (post-traumatic or elective) performed by any of them: relevant variations were also observed for the same type of intervention.
  
  
  CONCLUSIONS
  Combining information from different data sources could be a time-sparing way to gain useful information about transfusion practices, so contributing to optimising blood usage.
authors.affiliation: Transfusion Service Department of Clinical Pathology and Transfusion Medicine, Ravenna, Italy. f.verlicchi@ausl.ra.it
authors.forename: Franco
authors.initials: F
authors.lastname: Verlicchi
authors.forename: Fausto
authors.initials: F
authors.lastname: Desalvo
authors.forename: Gabriele
authors.initials: G
authors.lastname: Zanotti
authors.forename: Loretta
authors.initials: L
authors.lastname: Morotti
authors.forename: Ivana
authors.initials: I
authors.lastname: Tomasini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D019985:Benchmarking; D002648:Child; D003625:Data Collection; D017707:Erythrocyte Transfusion / Q000592:standards*; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult