An Audit of Requests for Fresh Frozen Plasma in a Tertiary Care Center in South India

Lingegowda, Jyothi B; Jeyakumar, Joshua Daniel; Muddegowda, Prakash H; Pitchai, R.; Niranjan, G; Sinha, Pammy

doi:10.4103/0974-2727.176232

Cited by 6 publications

(11 citation statements)

References 12 publications

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“…In the same study, the indication of the reversal of oral anticoagulant effect without bleeding was shown to be the rarest reason for improper FFP use, which is inconsistent with the results of our study 2 . Similarly, in a study by Pahuja et al and in another one by Lingegowda et al, it was reported that no improper FFP use was seen to reverse warfarin effect in their patient groups 6, 11. The hospital where our study was conducted is located in a densely populated area of settlement where the elderly are many in number; most of those who apply to the emergency department were of geriatric patient population.…”

Section: Discussionsupporting

confidence: 60%

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The evaluation of the audit of Fresh-Frozen Plasma (FFP) usage in emergency department

Emektar¹,

Dağar²,

Çorbacıoğlu³

et al. 2016

Turkish Journal of Emergency Medicine

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ObjectivesIn our study, the aim is to evaluate the use of Fresh-Frozen Plasma (FFP) in our emergency department and to assess its audit for transfusion.MethodsAll the patients aged 18 and over who received FFP transfusion in the emergency department between March 1, 2013 and March 1, 2016 were included into the study. The audit of FFP use was evaluated by according to ‘British Committee for Standards in Hematology Guideline-2004’.ResultsTotal 141 patients were identified to receive FFP transfusion in our emergency department. When the audit of FFP use was evaluated, 59.6% of all the practices were regarded as improper use. We identified that while the rate of improper use was 40.2% in patients with bleeding, it rose to 90.7% in patients without active bleeding or in those who used FFP with the aim of bleeding prophylaxis.ConclusionWe have determined that FFP transfusions were conducted with improper indications at high rate in our emergency department. Preparing an up-to-date transfusion guideline for the practices in emergency departments in our country and training and supervising the medical staff at regular intervals may help prevent the shortcomings in FFP practices.

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Section: Discussionsupporting

confidence: 60%

“…determined the improper use of FFP to be 45% in Canada, whereas, in Asian and European countries, the use of FFP with an improper indication ranged from 21% to 78% 2, 4, 6, 11, 12. In a study conducted in our country by Akkaş et al, the rate of improper use was found to be 67%, which is similar to the result in our study 13 .…”

Section: Discussionmentioning

confidence: 99%

The evaluation of the audit of Fresh-Frozen Plasma (FFP) usage in emergency department

Emektar¹,

Dağar²,

Çorbacıoğlu³

et al. 2016

Turkish Journal of Emergency Medicine

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“…1,18 In reference to audit of requests from clinical departments, Obstetrics and Gynecology topped the table in claiming for maximum requests with an overall issue rate of 8,100 among which issue for PRBC with anemia as a common underlying indication. 15 Most of the cases had multiple transfusions leading to adverse reaction due to varied antigenic exposure and same is the factor for adverse reactions among females. Allergic reaction was the second highest prevalence of adverse reaction observed to be associated with transfusion and it is noted in 43 cases (0.2% of overall transfusion) presenting as urticaria and rashes.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 In the year 2012, "the Haemovigilance Programme of India" was commissioned by the Indian Pharmacopoeia Commission in collaboration with the National Institute of Biologicals under the auspices of Pharmacovigilance Programme of India, with an objective to track ATR due to transfusion of blood and its components in all affiliated blood banks across the country. 6,15 Hemovigilance system serving as a backbone of quality assurance, the present study was carried out with a novel aim of determining incidence of adverse transfusion-related reactions and to substantiate its patterns encountered in our teaching hospital blood bank located in remote South-Eastern part of the Country. The study owns an objective to enlighten knowledge and insights into patterns of ATR in the study domain which is not yet documented with special emphasis on root cause analysis with appropriate corrective and preventive actions.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Patterns of Adverse Transfusion Reactions and Management: A Novel Initiative toward Hemovigilance in a Teaching Hospital of South India

et al. 2020

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Objective Blood transfusion being a major lifesaving frontline procedure in majority of clinical wards, has a high potential with risk for adverse events ranging in severity, thus warranting optimal usage of blood. Continuous monitoring of adverse transfusion reaction (ATR) and analysis of the reactions can promote better comprehension of various contributing risk factors. Hemovigilance being a quality indicator with data system assists in ensuring quality and safe blood transfusion. The present study was designed to analyze the incidence and nature of adverse transfusion-associated events reported to the blood bank from our teaching hospital located in the remote part of South-East Coastal region with emphasis on corrective and preventive actions. Materials and Methods The prospective study included all the ATR reported to our hospital blood bank over a period of 42 months. The transfusion reactions report forms filled by the clinicians were analyzed and the reactions were categorized into patterns. The associated risk factors for the reaction are evaluated with substantial laboratory and clinical parameters in reference to hemovigilance. Results Among 19,800 transfusions, 189 transfusion reactions were encountered with a ratio of 10:0.9 with age ranging from 12 to 80, with female preponderance. Reactions associated with whole blood (WB) transfusion were common (50%, p = 0.002) followed by packed red blood cells transfusion (PRBC) (1.4%, p = 0.006) and platelets (0.8%, p = 0.1). Febrile nonhemolytic transfusion reactions were predominant patterns noted in 122 cases followed by allergic reactions in 43 cases with more commonly associated PRBC transfusion whereas hemolytic reactions showed association with WB transfusion. No delayed reactions or mortalities were encountered. Conclusion The present study concludes with novelty showing the overall incidence of transfusion-associated reactions in the study domain is slightly higher than more advanced centers in India owing to lack of leukodepletion units which could enable to substantially retard the incidence of adverse events of transfusion as a general measure and febrile reactions in particular. Hemovigilance and pattern analysis of ATR provide scope for corrective and preventive action and give referral guidelines to prevent future recurrence.

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“…Similar findings were reported by Cheng and colleagues whereby they reviewed packed red blood cells (PRBC) cross-match requests and found inappropriate ordering was more pronounced for elective than emergency requests by 27.4% [ 30 ]. Several studies reported inappropriate requests among other blood components ranging from 22.2 to 42% [ 31 – 33 ]. All these studies show a large burden of inappropriate blood requests leading to unnecessary transfusions.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for inappropriate blood requisition among hospitals in Tanzania

et al. 2018

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BackgroundBlood is a critical aspect of treatment in life saving situations, increasing demand. Blood requisition practices greatly effect sufficient supply in blood banks. This study aimed to determine the risk factors for inappropriate blood requisition in Tanzania.MethodsThis was a cross sectional study using secondary data of 14,460 patients’ blood requests from 42 transfusion hospitals. Primary data were obtained by using cluster-sampling design. Data were analysed using a two-level mixed-effects Poisson regression to determine fixed-effects of individual-level factors and hospital level factors associated with inappropriate blood requests. P-value <0.05 (2-tails) was considered statistically significant.ResultsInappropriate requisition was 28.8%. Factors significantly associated with inappropriate requisition were; reporting pulse rate and capillary refill decrease the risk (RR 0.74; 95% CI 0.64, 0.84) and (RR 0.73; 95% CI 0.63, 0.85) respectively and the following increased the risk; having surgery during hospital stay (RR 1.22; 95% CI 1.06, 1.4); being in general surgical ward (RR 3.3; 95% CI 2.7, 4.2), paediatric ward (RR 1.8; 95% CI 1.2, 2.7), obstetric ward (RR 2.5; 95% CI 2.0, 3.1), gynaecological ward (RR 2.1; 95% CI 1.5, 2.9), orthopaedics ward (RR 3.8; 95% CI 2.2, 6.7). Age of the patient, pallor and confirmation of pre-transfusion haemoglobin level were also significantly associated with inappropriate requisition. Majority of appropriate requisitions within the wards were marked in internal medicine (91.7%) and gynaecological wards (77.8%).ConclusionsThe proportion of inappropriate blood requests was high. Blood requisition was determined by clinical and laboratory findings and the ward patients were admitted to. Adherence to transfusion guidelines is recommended to assure the best use of limited blood supply.

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An Audit of Requests for Fresh Frozen Plasma in a Tertiary Care Center in South India

Cited by 6 publications

References 12 publications

The evaluation of the audit of Fresh-Frozen Plasma (FFP) usage in emergency department

The evaluation of the audit of Fresh-Frozen Plasma (FFP) usage in emergency department

Analysis of Patterns of Adverse Transfusion Reactions and Management: A Novel Initiative toward Hemovigilance in a Teaching Hospital of South India

Risk factors for inappropriate blood requisition among hospitals in Tanzania

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