주요 수술의 최대혈액신청량 및 Adjacent Diagnosis Related Groups 환자분류체계에 따른 질환의 적혈구제제 평균수혈량의 설정 = Establishment of a Maximum Surgical Blood Order Schedule and Red Blood Cell Mean Transfusion Units Per Patient According to Adjacent Diagnosis Related Groups Patient Classification System

다국어 초록 (Multilingual Abstract)

Background: For effective management of blood components, periodic updates of the maximum surgical blood order schedule (MSBOS) using recent data are crucial. This study aimed to establish an updated MSBOS and red blood cell (RBC) mean transfusion units per patient according to the adjacent diagnosis related groups (ADRG) classification system.
Methods: This retrospective study was based on an audit of the medical records of inpatients at a tertiary hospital between January and December 2017. We investigated transfusion-related data to establish the MSBOS and determine the RBC mean transfusion units per patient according to the ADRG and compared these updated values with previous data.
Results: During the investigated period, a total of 5,607 RBC units were transfused in 17,382 patients. The revised MSBOS was similar to the previous MSBOS in most surgeries. Among the 130 ADRG codes analyzed, 34 codes showed an increase, while 96 codes showed a decrease in RBC mean transfusion units per patient, compared to data from 2007. Overall, the RBC mean transfusion units per patient in 2017 was 0.89 units less compared to that in 2007 after adjusting for age (95% CI: 0.853–0.912).
Conclusions: The revised MSBOS was similar to that of the previous versions. However, there were differences in the number of RBC transfusion units used in some surgeries and disease treatments compared to those in the past. Considering the changes within the medical environment, this study highlights the importance of periodic evaluation of MSBOS and RBC transfusion usage.

국문 초록 (Abstract)

배경: 효율적인 혈액제제 관리를 위하여 최근 수혈자료를 활용한 최대혈액신청량(maximum surgical blood order schedule, MSBOS)의 개정은 중요하다. 이 연구의 목적은 최대혈액신청량과 adjacent diagnosis related groups (ADRG) 코드 별 적혈구제제 평균수혈량을 설정하는 것이다.
방법: 본 연구는 한 상급종합병원의 2017년 1월부터 12월까지의 의무 기록을 바탕으로 한 후향적 연구이다. 수혈 관련 자료를 조사하여 최대혈액신청량과 ADRG 환자분류체계에 따른 적혈구제제 평균수혈량을 설정하였고, 과거 자료와 비교하였다.
결과: 2017년 17,382명의 환자에게 5,607단위의 적혈구제제가 수혈되었다. 새로 개정한 최대혈액신청량은 대부분의 수술에서 과거와 비슷하였다. 2007년 자료와 비교하였을 때 2017년의 평균수혈량이 130개의 ADRG 코드 중 34개 코드에서 증가하였고, 96개 코드에서는 감소하였다. 환자의 연령을 보정한 후 평균수혈량은 2007년에 비해 0.89단위 감소하였다(95% CI: 0.853-0.912).
결론: 개정된 최대혈액신청량은 과거와 거의 비슷하였으나 일부 수술과 질환에서의 수혈량은 차이가 있었다. 의료 환경의 변화를 고려할 때 최대혈액신청량과 적정 수혈량에 대한 주기적인 평가가 필요하다.

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