ISSN:
1432-055X
Keywords:
Schlüsselwörter Autologe Bluttransfusion
;
Bundesrepublik Deutschland
;
Umfrageergebnisse
;
Key words Autologous blood transfusion
;
Federal Republic of Germany
;
Survey
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Description / Table of Contents:
Abstract In 1993, we conducted a postal survey to assess the use of autologous blood transfusion (ABT) in the Federal Republic of Germany after reunification. The results of this survey have already been reported in a previous paper, but without differentiation between the “old” and “new” states (former West Germany and former German Democratic Republic, respectively). In the present study, the data of our 1993 survey were further analysed to see if there were differences in the use of ABT between the “old” and “new” states. Methods. The study is based on data of a 1993 postal survey of German hospitals. Details concerning the performance of the survey have been reported in a previous paper. Briefly, questionnaires were mailed to the anaesthesia departments of 400 randomly selected hospitals in the “old” states and 284 hospitals in the “new” states of the Federal Republic of Germany. The questionnaires contained 36 questions related to general information on the hospital and the use of ABT; 305 completed questionnaires were returned from the “old” states and 197 from the “new” states, response rates of 76% and 69%, respectively. For the present investigation, the responses of the hospitals of the “old” and “new” states were analysed separately. Frequency distributions of categorical variables were analysed by the chi-square test. Because of multiple testing, statistical significance was attained only at the 0.05% level (P≤0.0005). Results. There were no significant differences between the “old” and “new” states with respect to hospital size by number of beds, percentage of general and specialised hospitals, and percentage of operations requiring blood transfusion. In both the “old” and “new” states, 9% of the responding hospitals maintained a hospital-based transfusion service, while the other depended on regional blood banks. Preoperative autologous blood donation (PABD) was performed at least “rarely” in 85% and 71% (P=0.0001), and “mostly” in 20% and 10% (P=0.0014) of the hospitals in the “old” and “new” states, respectively. Uniformly, the principal uses of PABD were for orthopaedic and cardiac surgery. In 62% and 27% (P〈0.0001) of those hospitals that reported performing PABD, the autologous blood service was run by the anaesthesia department. Preoperative plasmapheresis was performed in 14% and 8% (P=0.008), and isovolaemic haemodilution in 82% and 56% (P〈0.0001) of the hospitals in the “old” and “new” states, respectively. Automated autotransfusion devices (cell savers) were available in 38% and 19% (P〈0.0001) of the hospitals, respectively. Simple collection devices for perioperative blood salvage were used in 17% and 15% (P=0.24) of the hospitals in the “old” and “new” states, respectively. Conclusion. We conclude that ABT is more widely used in the “old” than the “new” states of the Federal Republic of Germany. ABT is regarded as a desirable alternative to homologous blood transfusion, and in the interest of equal standards of medical care throughout the nation, the use of ABT should be further promoted, especially in the “new” states of the Federal Republic of Germany.
Notes:
Zusammenfassung Die Verbreitung autologer Bluttransfusionsverfahren in den alten und neuen Bundesländern wird miteinander verglichen. Dem Vergleich liegen die Ergebnisse einer Fragebogenerhebung aus dem Jahre 1993 zugrunde, über die wir ohne Unterscheidung zwischen alten und neuen Bundesländern bereits berichteten. Bei der Umfrage waren 400 Krankenhäuser aus den alten und 284 Krankenhäuser aus den neuen Bundesländern zur Praxis der autologen Bluttransfusion um Auskunft gebeten worden. 305 bzw. 197 Krankenhäuser (76% bzw. 69%) hatten geantwortet. Die beiden Antwortkollektive waren nach der Krankenhausbettenzahl, der Versorgung durch transfusionsmedizinische Einrichtungen und dem Aufkommen an Eingriffen mit Transfusionsbedarf nicht signifikant verschieden. In 85% bzw. 71% der Krankenhäuser (alte bzw. neue Bundesländer) war eine präoperative Eigenblutspende möglich. Der Anteil der Krankenhäuser, in denen dieses Verfahren „meistens“ eingesetzt wurde, war in den alten Bundesländern doppelt so hoch wie in den neuen Bundesländern (20% bzw. 10%). 82% bzw. 56% der Krankenhäuser (alte bzw. neue Bundesländer) machten zumindest fallweise von der Möglichkeit der akuten isovolämischen Hämodilution Gebrauch. Die präoperative Plasmapherese und die maschinelle Autrotransfusion waren in den alten Bundesländern doppelt so weit verbreitet wie in den neuen Bundesländern (14% bzw. 8% und 38% bzw. 19% der Krankenhäuser). Die Untersuchung hat gezeigt, daß bezüglich der Verbreitung autologer Transfusionsverfahren in den neuen Bundesländern ein erheblicher Nachholbedarf gegenüber den alten Bundesländern besteht.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001010050293
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