Retrospective Analysis of the Blood Component Utilization in a University Hospital of Maximum Medical Care

Abstract

Background: Demographic data illustrate clearly that people in highly developed countries get older, and the elderly need more blood transfusions than younger patients. Additionally, special extensive therapies result in an increased consumption of blood components. Beyond that the aging of the population reduces the total number of preferably young and healthy blood donors. Therefore, Patient Blood Management will become more and more important in order to secure an increasing blood supply under fair-minded conditions. Methods: At the University Hospital of Münster (UKM) a comprehensive retrospective analysis of the utilization of all conventional blood components was performed including all medical and surgical disciplines. In parallel, a new medical reporting system was installed to provide a monthly analysis of the transfusional treatments in the whole infirmary, in every department, and in special blood-consuming cases of interest, as well. Results: The study refers to all UKM in-patient cases from 2009 to 2011. It clearly demonstrates that older patients (>60 years, 35.2–35.7% of all cases, but 49.4–52.6% of all cases with red blood cell (RBC) transfusions, 36.4–41. 6% of all cases with platelet (PTL, apheresis only) transfusions, 45.2– 48.0% of all cases with fresh frozen plasma (FFP) transfusions) need more blood products than younger patients. Male patients (54.4–63.9% of all cases with transfusions) are more susceptible to blood transfusions than female patients (36.1–45.6% of all cases with transfusions). Most blood components are used in cardiac, visceral, and orthopedic surgery (49.3–55.9% of all RBC units, 45.8–61.0% of all FFP units). When regarding medical disciplines, most transfusions are administered to hematologic and oncologic patients (12.9–17.7% of all RBC units, 9.2– 12.0% of all FFP units). The consumption of PTL in this special patient cohort (40.6–50.9% of all PTL units) is more pronounced than in all other surgical or in non-surgical disciplines. Conclusion: The results obtained from our retrospective analysis may help to further optimize the responsible and medical indication-related utilization of blood transfusions as well as the recruitment of blood donors and their timing. It may be also a helpful tool in order to avoid needless transfusions and transfusion-associated adverse events.

Utilisation of Blood Components in Cardiac Surgery: A Single-Centre Retrospective Analysis with Regard to Diagnosis-Related Procedures

“…The data obtained in our retrospective analysis are in agreement with previously published results concerning the overall blood consumption of RBC, FFP and PLT units in cardiac surgery [1,2,3,4,5,6,13]. The percentage of patients requiring RBC, FFP or PLT units noticeably decreased after the introduction of the PBM measures in January 1, 2012, whereas significantly more blood (RBCs) per patient was provided in 2012 (7,253 RBC units) compared to 2009 (5,998 RBC units), which might reflect the above mentioned complexity factor.…”

“…In many hospitals that provide comprehensive medical care, the usage of blood components during cardiac surgery is much greater than the average blood product demand in most other medical disciplines [1,2,3,4,5,6]. Today, blood transfusions have become more and more accepted as a major quality indicator in cardiac surgery [7,8,9].…”

“…Several anticipatory efforts to moderate the consequences of these demographic changes have been made by blood donation establishments and hospital-related programmes of patient blood management (PBM) [6,22,23]. For example, the prophylactic treatment of pre-operative anaemia with iron deficiency through the intravenous application of iron was applied to reduce the peri-operative [23,24,25,26] and intensive care demand [27] of red blood cell (RBC) transfusions.…”

“…One of the long-term objectives of this programme was to improve adherence to the (inter-)national guidelines and in-house transfusion algorithms aiming at the avoidance of needless blood transfusions and transfusion-related adverse events and to reduce the transfusion-associated costs. To achieve this goal, a retrospective study was performed linking blood utilisation to diagnosis- or medical procedure-driven groups in order to analyse the blood component consumption within all medical departments of the UKM in detail [6]. …”

Blood Product Supply in Germany: The Impact of Apheresis and Pooled Platelet Concentrates

“…Hemato-oncological patients comprised 37.1% of all cases and received 50.9% of transfused units of PCs [27]. A study on PC use in the North of England in 2012 showed similarly that 60.5% of PC transfusions were given to hemato-oncological patients.…”