Demographic and epidemiologic characterization of transfusion recipients from four US regions: evidence from the REDS‐III recipient database

Abstract

Introduction Blood transfusion is one of the most common medical procedures during hospitalization in the United States. To understand the benefits of transfusion while mitigating potential risks, a multicenter database containing detailed information on transfusion incidence and recipient outcomes would facilitate research. Methods The Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) program has developed a comprehensive transfusion recipient database utilizing data from hospital electronic health records at 12 participating hospitals in four geographic regions. Transfused inpatient and outpatient data from January 1, 2013 until December 31, 2014 included patient age, sex, ethnicity, primary diagnosis, type of blood product provided, issue location, pre- and post-transfusion hemoglobin, and hospital outcomes. Transfusion incidence per encounter was calculated by blood product and various patient characteristics. Results During the two-year study period, 80,362 (12.5%) inpatient encounters involved transfusion. Among inpatients, the most commonly transfused blood products were red cells (10.9% of encounters), followed by platelets (3.2%), and plasma (2.9%). Among transfused patients, the median number of red-cell units was one, pre-transfusion hemoglobin was 7.6 g/dL, and hemoglobin increment/unit was 1.4 g/dL. Encounter mortality increased with patient age, number of units transfused, and the use of platelet or plasma products. The most common reported transfusion reaction was febrile non-hemolytic. Conclusion The REDS-III recipient database contains comprehensive data regarding transfusion use and patient outcomes. This report describes an evaluation of the first two years of a planned four-year linked blood donor-component-recipient database which represents a critical new resource for transfusion medicine researchers.

Frequent blood donations alter susceptibility of red blood cells to storage‐ and stress‐induced hemolysis

“…For example, we have identified patients who received RBC units from RBC-Omics donors, and for whom the REDS-III program has recipient outcome data, including pre−/posttransfusion hemoglobin increments, in the linked donor-recipient database. [41][42][43] In addition, subsequent studies are planned that will recall selected RBC-Omics donors with extremes of hemolysis parameters or identified genetic polymorphisms that were identified in our genome-wide association study to determine in vivo RBC survival based on biotin labeling [44][45][46] and transfusion of autologous stored RBC samples.…”

Trends and outcomes in multicomponent blood transfusion: an 11‐year cohort study of a large multisite academic center

“…With respect to health outcomes, multivariable regression analysis controlling for a variety of factors including illness burden and severity showed that multicomponent transfusion was associated with increased odds of in‐hospital mortality, increased odds of institutional discharge as opposed to discharge home, and greatly prolonged hospital LOS, as compared to patients receiving only RBC transfusions. Of note, our study compared multicomponent transfusion to transfusion of only RBCs, as RBCs are the most frequently transfused single blood component type; however, Karafin et al have suggested that transfusions of only PLTs or only FP may be associated with poorer outcomes (e.g., higher mortality rates) compared to RBC‐only transfusions. Although patients transfused with only PLTs or only FP are much less frequent than those receiving only RBCs, and present different indications for transfusion, it would be of interest for future studies to compare multicomponent transfusion to transfusion of only PLTs and only FP with respect to patient outcomes.…”

“…Blood transfusion is the most common procedure performed in hospital, occurring in a variety of patient populations and hospital settings . Patients may receive transfusions of a single blood component (e.g., only red blood cells [RBCs]), or they may be transfused with several different blood products (multicomponent transfusion).…”

“…Some studies have previously reported on the epidemiology of multicomponent transfusion . However, multicomponent transfusion was not their primary focus, and almost a quarter of the studies were published only as conference abstracts, resulting in limited information and detail provided on multicomponent transfusion, which indicates the need for further, more detailed research on this topic.…”

Red blood cell utilization and transfusion triggers in patients diagnosed with chronic lymphocytic leukaemia in Iceland 2003–2016

“…Patients with haematological disorders account for 6Á9-8Á8% of red cell units transfused according to recent studies [10,11]. Not many studies have been published on RBC transfusion practises in haematological malignancies and still fewer for specific diseases like CLL [12,13].…”