The epidemiology of red cell transfusion

Barr, Paul; Donnelly, Michael; Morris, K.; Parker, Michael; Cardwell, Christopher; Bailie, K.

doi:10.1111/j.1423-0410.2010.01349.x

Cited by 28 publications

(34 citation statements)

References 25 publications

(54 reference statements)

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“…In addition, a specific distribution pattern is recognizable depending on the blood component or medical discipline. In our study, male patients on average need more RBC, PTL, and FFP transfusions than female ones, and older more than younger patients, confirming results published earlier [11,12,19,20]. The age-and gender-related findings for RBC transfusions from the UKM are similar to the results published in other regions [14,21,22].…”

Section: Discussionsupporting

confidence: 82%

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

Geissler

Franz²,

Buddendick³

et al. 2012

Transfus Med Hemother

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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.

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Section: Discussionsupporting

confidence: 82%

“…For RBC transfusions exclusively, similar data were published in Finland [24], in North East England [21], in the USA [19], and in Northern Ireland [20].…”

Section: Disclosure Statementsupporting

confidence: 49%

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

Geissler

Franz²,

Buddendick³

et al. 2012

Transfus Med Hemother

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“…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.…”

Section: Discussionsupporting

confidence: 82%

“…This trend has been partially affirmed in other countries as well [11]. Due to the increased number of surgical interventions and their progressive complexity, particularly in higher-developed countries [1,4,12,13,14,15,16], the demand for blood products has increased globally, as noted by a demographic analysis [17]. Additionally, older patients require more blood transfusions [14,18,19] as a result of progress in medical sciences and therapeutic options [17].…”

Section: Introductionmentioning

confidence: 99%

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

Geissler

Rotering

Buddendick

et al. 2015

Transfus Med Hemother

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Background: More blood components are required in cardiac surgery than in most other medical disciplines. The overall blood demand may increase as a function of the total number of cardiothoracic and vascular surgical interventions and their level of complexity, and also when considering the demographic ageing. Awareness has grown with respect to adverse events, such as transfusion-related immunomodulation by allogeneic blood supply, which can contribute to morbidity and mortality. Therefore, programmes of patient blood management (PBM) have been implemented to avoid unnecessary blood transfusions and to standardise the indication of blood transfusions more strictly with aim to improve patients' overall outcomes. Methods: A comprehensive retrospective analysis of the utilisation of blood components in the Department of Cardiac Surgery at the University Hospital of Münster (UKM) was performed over a 4-year period. Based on a medical reporting system of all medical disciplines, which was established as part of a PBM initiative, all transfused patients in cardiac surgery and their blood components were identified in a diagnosis- and medical procedure-related system, which allows the precise allocation of blood consumption to interventional procedures in cardiac surgery, such as coronary or valve surgery. Results: This retrospective single centre study included all in-patients in cardiac surgery at the UKM from 2009 to 2012, corresponding to a total of 1,405-1,644 cases per year. A blood supply was provided for 55.6-61.9% of the cardiac surgery patients, whereas approximately 9% of all in-patients at the UKM required blood transfusions. Most of the blood units were applied during cardiac valve surgery and during coronary surgery. Further surgical activities with considerable use of blood components included thoracic surgery, aortic surgery, heart transplantations and the use of artificial hearts. Under the measures of PBM in 2012 a noticeable decrease in the number of transfused cases was observed compared to the period from 2009 to 2011 before implementation of the PBM initiative (red blood cells p < 0.002; fresh frozen plasma p < 0.0006; platelets p < 0.00006). Conclusion: Until now, cardiac surgery comes along with a significant blood supply. By using a case-related data evaluation programme, the consumption of each blood component can be linked to clinical performance groups and, if necessary, to individual patients. Based on the results obtained from this retrospective analysis, prospective studies are underway to begin conducting target / actual performance comparisons to better understand the individual decision-making by the attending physicians with respect to transfusions.

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“…It can be argued that no universal cut-off values exist as to whether electronic health data are “valid” or of “high quality” [21], since the level of data quality required will also depend on the purpose of the study concerned. Still, objective measures for relevant quality concepts are necessary, and an adequate understanding of how to interpret validity outcomes is desirable.…”

Section: Discussionmentioning

confidence: 99%

Validation of multisource electronic health record data: an application to blood transfusion data

Hoeven

Bruijne

Kemper

et al. 2017

BMC Med Inform Decis Mak

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BackgroundAlthough data from electronic health records (EHR) are often used for research purposes, systematic validation of these data prior to their use is not standard practice. Existing validation frameworks discuss validity concepts without translating these into practical implementation steps or addressing the potential influence of linking multiple sources. Therefore we developed a practical approach for validating routinely collected data from multiple sources and to apply it to a blood transfusion data warehouse to evaluate the usability in practice.MethodsThe approach consists of identifying existing validation frameworks for EHR data or linked data, selecting validity concepts from these frameworks and establishing quantifiable validity outcomes for each concept. The approach distinguishes external validation concepts (e.g. concordance with external reports, previous literature and expert feedback) and internal consistency concepts which use expected associations within the dataset itself (e.g. completeness, uniformity and plausibility). In an example case, the selected concepts were applied to a transfusion dataset and specified in more detail.ResultsApplication of the approach to a transfusion dataset resulted in a structured overview of data validity aspects. This allowed improvement of these aspects through further processing of the data and in some cases adjustment of the data extraction. For example, the proportion of transfused products that could not be linked to the corresponding issued products initially was 2.2% but could be improved by adjusting data extraction criteria to 0.17%.ConclusionsThis stepwise approach for validating linked multisource data provides a basis for evaluating data quality and enhancing interpretation. When the process of data validation is adopted more broadly, this contributes to increased transparency and greater reliability of research based on routinely collected electronic health records.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-017-0504-7) contains supplementary material, which is available to authorized users.

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The epidemiology of red cell transfusion

Cited by 28 publications

References 25 publications

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

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

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

Validation of multisource electronic health record data: an application to blood transfusion data

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