Évaluation multicentrique de la pertinence des prescriptions de concentrés de globules rouges

Gouëzec, H.; Berger, É.; Bergoin-Costello, V.; Betbeze, Véronique; Bourcier, Véronique; Damais, A.; Drouet, N.; Ducroz, S.; Fialon, P.; Herve, Isabelle; Huchet, C.; Lassale, B.; Léo, S.; Lovi, V.; Niger, Catherine Le; Moron, S.; Renom, P.; Delaunay, C.; Turmel, Valérie

doi:10.1016/j.tracli.2010.09.154

Cited by 10 publications

(9 citation statements)

References 21 publications

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“…However, integration of guidelines into practice has been variable, with a significant proportion of RBC units transfused outside of evidence-based indications [15-18]. It has been hypothesized that clinicians modify their transfusion decisions by incorporating patient comorbidities or severity of illness [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Predicting red blood cell transfusion in hospitalized patients: role of hemoglobin level, comorbidities, and illness severity

Roubinian

Murphy

Swain

et al. 2014

BMC Health Serv Res

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BackgroundRandomized controlled trial evidence supports a restrictive strategy of red blood cell (RBC) transfusion, but significant variation in clinical transfusion practice persists. Patient characteristics other than hemoglobin levels may influence the decision to transfuse RBCs and explain some of this variation. Our objective was to evaluate the role of patient comorbidities and severity of illness in predicting inpatient red blood cell transfusion events.MethodsWe developed a predictive model of inpatient RBC transfusion using comprehensive electronic medical record (EMR) data from 21 hospitals over a four year period (2008-2011). Using a retrospective cohort study design, we modeled predictors of transfusion events within 24 hours of hospital admission and throughout the entire hospitalization. Model predictors included administrative data (age, sex, comorbid conditions, admission type, and admission diagnosis), admission hemoglobin, severity of illness, prior inpatient RBC transfusion, admission ward, and hospital.ResultsThe study cohort included 275,874 patients who experienced 444,969 hospitalizations. The 24 hour and overall inpatient RBC transfusion rates were 7.2% and 13.9%, respectively. A predictive model for transfusion within 24 hours of hospital admission had a C-statistic of 0.928 and pseudo-R2 of 0.542; corresponding values for the model examining transfusion through the entire hospitalization were 0.872 and 0.437. Inclusion of the admission hemoglobin resulted in the greatest improvement in model performance relative to patient comorbidities and severity of illness.ConclusionsData from electronic medical records at the time of admission predicts with very high likelihood the incidence of red blood transfusion events in the first 24 hours and throughout hospitalization. Patient comorbidities and severity of illness on admission play a small role in predicting the likelihood of RBC transfusion relative to the admission hemoglobin.

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Section: Introductionmentioning

confidence: 99%

“…It has been hypothesized that clinicians modify their transfusion decisions by incorporating patient comorbidities or severity of illness [15,16]. These factors might partially explain observed variation in RBC transfusion practice.…”

Section: Introductionmentioning

confidence: 99%

Predicting red blood cell transfusion in hospitalized patients: role of hemoglobin level, comorbidities, and illness severity

Roubinian

Murphy

Swain

et al. 2014

BMC Health Serv Res

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show abstract

“…A higher rate of disagreement was found in the prescriptions of fresh frozen plasma (74%) (21) . A French study on adherence to the national protocol observed conformity in 93% of the RBC transfusions (22) . Ghali (23) concluded that up to 55.3% of RBC transfusions were unnecessary.…”

Section: Resultsmentioning

confidence: 99%

“…Their indiscriminate use carries the risk of increased susceptibility to hospital-acquired infections, transmission of infectious diseases, TRALI, increased expenditure and mortality in critically ill patients (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) . Several research groups have studied the unnecessary use of blood products (15,16,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) . In a study at the Melbourne Royal Hospital, Metz the importance of the blood bank staff reviewing the indications for blood transfusions as well as the formation of a transfusion committee (29,30) .…”

Section: Discussionmentioning

confidence: 99%

Critical evaluation of justifications for the transfusion of red blood cells: the reality of a government emergency hospital

Souza¹,

Silva²,

Costa³

2013

Revista Brasileira De Hematologia E Hemoterapia

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“…An observational study of transfused obstetric patients in two Dutch hospitals noted that of 311 RBC units transfused to 90 patients, 143 units (46%) were possibly inappropriate partly due to over-transfusion (13) .…”

mentioning

confidence: 99%

Rational use of blood: how to do it?

Moraes‐Souza¹

2013

Revista Brasileira De Hematologia E Hemoterapia

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Évaluation multicentrique de la pertinence des prescriptions de concentrés de globules rouges

Cited by 10 publications

References 21 publications

Predicting red blood cell transfusion in hospitalized patients: role of hemoglobin level, comorbidities, and illness severity

Predicting red blood cell transfusion in hospitalized patients: role of hemoglobin level, comorbidities, and illness severity

Critical evaluation of justifications for the transfusion of red blood cells: the reality of a government emergency hospital

Rational use of blood: how to do it?

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