Patient Blood Management Adoption and Transfusion-Threshold Concordance Among Romanian Anesthesiologists: National Survey Analysis
Abstract
BackgroundRomania issued national patient blood management (PBM) guidelines in 2018. A 2023 national survey described the overall uptake of PBM among anesthesiologists but did not examine which clinicians and institutions adopted PBM, nor whether stated transfusion thresholds aligned with a study-defined restrictive reference. ObjectiveThis study aimed to identify determinants of PBM adoption and to quantify transfusion-trigger concordance, using a planned, exploratory, cross-sectional secondary analysis of the 2023 survey. MethodsWe analyzed 511 responses to the 38-item Romanian Society of Anaesthesia and Intensive Care (SRATI) PBM survey. Three adoption outcomes (applying PBM, a formal hospital PBM group, and routine preoperative anemia treatment) were modeled by multivariable logistic regression against physician grade, hospital category, and local PBM educational events. Eight standardized clinical vignettes (age×cardiac disease×bleeding state) were scored against a restrictive hemoglobin reference (7 g/dL general; 8 g/dL with cardiac disease). The reported timing of the preanesthetic consultation (4 frequency items) was additionally examined as a determinant of preoperative anemia treatment. This was a planned, exploratory secondary analysis; the robustness of the main findings was examined in sensitivity analyses that accounted for survey attrition and for alternative transfusion-threshold scoring rules. ResultsOverall, 73.7% (373/506) reported applying PBM, 33.1% (158/477) reported a formal PBM group, and 33.5% (117/349) reported routine preoperative anemia treatment. Local PBM educational events were the strongest adjusted correlate of reported adoption (applying PBM: adjusted odds ratio [aOR] 9.78, 95% CI 4.33‐22.07; PPPPP ConclusionsIn this exploratory cross-sectional analysis, reported PBM adoption was associated more strongly with local educational activity than with hospital category or physician seniority. Self-reported PBM application was not associated with restrictive stated thresholds in hypothetical scenarios, and respondents selected more liberal thresholds for older patients. Standardized multidisciplinary pathways, earlier anemia screening shared with the surgical team, and education focused on transfusion decisions may help address these gaps. Prospective studies using observed process measures, transfusion practice, and clinical outcomes are needed.
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BibTeX
@article{stefan2026patient,
title = {{Patient Blood Management Adoption and Transfusion-Threshold Concordance Among Romanian Anesthesiologists: National Survey Analysis}},
author = {Mihai Gabriel Stefan and Daniela Filipescu and Dan Corneci and Cornelia Predoi and Silvius Negoita and Dorel Sandesc and Liana Valeanu and Serban Ion Bubenek Turconi and Stefan Andrei and Dana Tomescu},
journal = {JMIR Perioperative Medicine},
year = {2026},
month = oct,
doi = {10.2196/106731},
url = {https://doi.org/10.2196/106731},
note = {CC BY},
}
RIS
TY - JOUR
TI - Patient Blood Management Adoption and Transfusion-Threshold Concordance Among Romanian Anesthesiologists: National Survey Analysis
AU - Mihai Gabriel Stefan
AU - Daniela Filipescu
AU - Dan Corneci
AU - Cornelia Predoi
AU - Silvius Negoita
AU - Dorel Sandesc
AU - Liana Valeanu
AU - Serban Ion Bubenek Turconi
AU - Stefan Andrei
AU - Dana Tomescu
PY - 2026
DA - 2026/10/23
JO - JMIR Perioperative Medicine
DO - 10.2196/106731
UR - https://doi.org/10.2196/106731
AB - BackgroundRomania issued national patient blood management (PBM) guidelines in 2018. A 2023 national survey described the overall uptake of PBM among anesthesiologists but did not examine which clinicians and institutions adopted PBM, nor whether stated transfusion thresholds aligned with a study-defined restrictive reference. ObjectiveThis study aimed to identify determinants of PBM adoption and to quantify transfusion-trigger concordance, using a planned, exploratory, cross-sectional secondary analysis of the 2023 survey. MethodsWe analyzed 511 responses to the 38-item Romanian Society of Anaesthesia and Intensive Care (SRATI) PBM survey. Three adoption outcomes (applying PBM, a formal hospital PBM group, and routine preoperative anemia treatment) were modeled by multivariable logistic regression against physician grade, hospital category, and local PBM educational events. Eight standardized clinical vignettes (age×cardiac disease×bleeding state) were scored against a restrictive hemoglobin reference (7 g/dL general; 8 g/dL with cardiac disease). The reported timing of the preanesthetic consultation (4 frequency items) was additionally examined as a determinant of preoperative anemia treatment. This was a planned, exploratory secondary analysis; the robustness of the main findings was examined in sensitivity analyses that accounted for survey attrition and for alternative transfusion-threshold scoring rules. ResultsOverall, 73.7% (373/506) reported applying PBM, 33.1% (158/477) reported a formal PBM group, and 33.5% (117/349) reported routine preoperative anemia treatment. Local PBM educational events were the strongest adjusted correlate of reported adoption (applying PBM: adjusted odds ratio [aOR] 9.78, 95% CI 4.33‐22.07; PPPPP ConclusionsIn this exploratory cross-sectional analysis, reported PBM adoption was associated more strongly with local educational activity than with hospital category or physician seniority. Self-reported PBM application was not associated with restrictive stated thresholds in hypothetical scenarios, and respondents selected more liberal thresholds for older patients. Standardized multidisciplinary pathways, earlier anemia screening shared with the surgical team, and education focused on transfusion decisions may help address these gaps. Prospective studies using observed process measures, transfusion practice, and clinical outcomes are needed.
SN - 2561-9128
ER -