Trends in Red Blood Cell, Plasma, and Platelet Transfusions in the United States, 1993-2014

Abstract

Blood transfusions are one of the most common hospital procedures. Randomized trials have demonstrated the safety of restrictive transfusion strategies. 1 Hospitals have subsequently implemented patient blood management programs to facilitate restrictive transfusion practices aimed to improve patient outcomes, reduce costs, and conserve blood. We are unaware of nationally representative studies evaluating temporal trends in red blood cell (RBC), plasma, and platelet transfusions while accounting for the influence of patient-level or hospitallevel characteristics.

Sociodemographic and behavioral characteristics associated with blood donation in the United States: a population‐based study

“…Blood transfusion is a lifesaving procedure that is integral to the management of many surgical and medical pathologies. In the United States (U.S.), blood transfusion rates have steadily declined over 30% in the past decade . Several factors have contributed to this decline, including the availability of revised clinical guidelines, implementation of patient blood management programs, an expanded repertoire of marrow‐sparing and hemostatic agents, and an increase in the practice of minimally invasive surgeries .…”

“…Several factors have contributed to this decline, including the availability of revised clinical guidelines, implementation of patient blood management programs, an expanded repertoire of marrow‐sparing and hemostatic agents, and an increase in the practice of minimally invasive surgeries . Despite these advancements, blood transfusion remains common in U.S. hospitals …”

Critical developments of 2018: A review of the literature from selected topics in transfusion. A committee report from the AABB's Clinical Transfusion Medicine Committee

“…The results demonstrated a continued downtrend of blood collections and transfusions (Table ). A study using the National Inpatient Sample also found decreases in the proportion of inpatients receiving transfusions (Table ). Several factors have contributed to this decline, including better surgical techniques, and implementation of patient blood management programs.…”

The argument(s) for lowering the US minimum required content of apheresis platelet components

“…RBC use has declined by approximately 25% to 30% in the United States, without measured adverse effects on patient outcomes and with reduced costs . During the same period, the practice of PC transfusion has changed very little: Minimum prophylactic platelet count transfusion thresholds are well defined in nonbleeding, hospitalized, thrombocytopenic hematology/oncology patients, but these account for less than one‐half of PC transfusions . Use is more variable in the outpatient and surgical settings .…”