Audit of clinical use of red blood cells in a tertiary care setting: An algorithmic approach!

Tiwari, Aseem Kumar; Ratan, Ankita; Arora, Dinesh; Aggarwal, Geet; Mehta, Sharad; Setya, Divya; Acharya, Devi Prasad

doi:10.4103/gjtm.gjtm_36_17

Cited by 6 publications

(5 citation statements)

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“…In the current study; a significant association was seen between the hematological (hemoglobin, hematocrit, red blood cell, platelet, and white blood cells) parameters of pre-transfused results with that of post transfused result (P-value <0.05) ( Table 4 ) which is in line with the study conducted in India, 17 in Italy 18 and a study conducted in BLSH, Ethiopia. 13 The overall transfusion rate of this study was 97.3% which is higher than a study conducted in India which reports 90.0%, 19 retrospective study conducted in India which reports 62.6%, 20 a study conducted in Jimma, Ethiopia which reports 82.1%, 10 a study conducted in Gondar, Ethiopia which reports 47% 7 and nearly similar with a study finding conducted in Nigeria which reports 94.42%. 14 However, in the current study, the utilization of blood components rather than whole blood was minimal, which is less than 12.5%.…”

Section: Discussionsupporting

confidence: 74%

Assessment of Blood Transfusion Utilization and Patient Outcomes at Yekatit-12 Hospital, Addis Ababa, Ethiopia

Tewabe¹,

Mitiku²,

Worku³

2022

JBM

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Background The goal of blood transfusion is to provide a safe, sufficient, and timely supply of blood components to the recipients by ensuring that donation is safe and no harm to the recipient. So the current study was aimed to assess blood transfusion utilization and its outcome in patients at Yekatit-12 Hospital, Addis Ababa, Ethiopia. Methods A cross-sectional study was conducted from May 01 to July 30, 2021, on 616 individuals who have requested blood transfusion at Yekatit-12 Hospital, Addis Ababa, Ethiopia. Information on blood and blood component utilization was collected by using a checklist. Finally, data were analyzed using SPSS version 21.0, and those variables in which P-value is less than 0.05 were considered statistically clinically significant. Results A total of 1540 cross-match units were requested for 616 (53.2% male) patients with a mean age of 43 years. Out of 1540 cross-matched blood units, 1498 units of blood were transfused for 615 individuals with a mean of 2.43 units. The most widely used blood component was whole blood 694 (46.3%) and 1252 (83.6%) of the blood unit were “RH” positive. From a total of 68 (11.1%) none improved reported cases, 48 (10.5%) were those transfused with whole blood transfusion. The proportion of improvement after transfusion according to the service ranged from 83.3.0% to 100% and no post-transfusion reactions were reported. A significant improvement was seen in the hematological profile (hemoglobin, red blood cells, hematocrit, platelets, and white blood cells) findings of the transfused individuals after blood unit transfusion (P < 0.05). Conclusion The overall utilization rate and improvement status after transfusion were high even if the utilization rate has some limitations. The overall ratios of cross-match to transfusion ratio, transfusion probability, and transfusion index were 1.03, 99.8%, and 0.97, respectively.

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Section: Discussionsupporting

confidence: 74%

Assessment of Blood Transfusion Utilization and Patient Outcomes at Yekatit-12 Hospital, Addis Ababa, Ethiopia

Tewabe¹,

Mitiku²,

Worku³

2022

JBM

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“…Overall, 82.1% transfusion appropriateness was recorded in this study which is lower than a report of 90.0% by Tiwari et al [18] but higher than the study reported by Richa et al of 62.6% [25] and Zhu et al of 37.3% [69], but only 27.8% of recipients received appropriate component transfusions. This was due to the use of whole blood as a sole component for transfusion in resource-limited areas [20,50] and also 97% whole blood transfusion in this study of all patients.…”

Section: Plos Onecontrasting

confidence: 75%

“…Overall, 82.1% transfusion appropriateness was recorded in this study which is lower than a report of 90.0% by Tiwari et al . [ 18 ] but higher than the study reported by Richa et al . of 62.6% [ 25 ] and Zhu et al .…”

Section: Discussionmentioning

confidence: 61%

“…For these reasons, however, the provision of hospital transfusion services remains under greater pressure in the context of blood safety, availability, and cost [ 17 ] depending on the overall healthcare status of that specific area [ 2 , 10 ]. Blood transfusion therapy aims in providing the patient with appropriate blood components for specific hematologic deficiencies that the patient has rather than transfusing whole blood [ 18 ]. This practice is supported by the central dogma of transfusion “giving a patient only the blood components that the patient needs” [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of recipients’ characteristics, transfusion appropriateness, and utilization pattern of blood and blood products in Jimma Medical Center, Jimma, Ethiopia

2021

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Background As blood transfusion remains life-saving and is being frequently prescribed, a greater number of its practice is unnecessary or inappropriate. This important clinical intervention is reported as one of the five overused medical treatments, with gross over-ordering and whole blood transfusions as the sole component being common in developing countries. Study of recipient’s demographics, clinical conditions, appropriate blood utilization, and continuous clinical audits for quality assurance and service improvement plan are important factors to this practice. This study was designed to assess the recipient’s characteristics, blood type distributions, appropriateness of blood transfusion, and utilization practice of the big medical center. Methods Institution based cross-sectional study was conducted from February 1 to June 30, 2018. Data were collected using a structured data collection format prepared for this study. All transfusion prescriptions were followed from requisition up to completion. Patient’s age, sex, requesting departments, hemodynamics, number and component of units requested and issued, and units transfused were collected. Transfusion appropriateness was assessed by a criterion-based method while blood utilization was calculated. Results A total of 545 units of blood for 425 patients were cross-matched of the 809 units of total blood prescribed. The mean and median age of transfused individuals was found to be 27.47 ±15.28 years and 26 years respectively, and 65.4% females most in reproductive age groups. O and A Rhesus-positive blood types were the two major blood groups observed. Overall 82.1% of transfusions were appropriate; while only 27.8% of patients received appropriate components as 96.5% of individuals received a whole blood transfusion. Significant blood utilization was recorded with a C/T ratio of 1.05, TP% of 100%, and TI of 1.23. Conclusion Much of the transfusion recipients were relatively young aged and females, most in the reproductive age group. Although whole blood was used as a sole component, significant blood transfusion utilization and appropriateness were recorded; while appropriate component transfusion was recorded to be significantly low. Local transfusion guidelines and appropriate component preparation and utilization are required to improve the sub-optimal blood component transfusion practice.

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“…A study done in a tertiary care setting in India also showed a similar mean increase in hemoglobin level posttransfusion. 10 This value is lower than the expected increase in hemoglobin level after a unit of blood transfusion. This discrepancy could be due to different reasons, including the age and sex of the donor 11 , hemoglobin content in the unit, weight of the patient, and the cause of anemia.…”

Section: Discussionmentioning

confidence: 72%

Increment in hemoglobin and hematocrit levels after blood transfusion in a tertiary care hospital

Shah¹,

Shrestha²,

Rajbhandari³

et al. 2022

J Pathol Nep

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Background: Blood transfusion is considered to be the first line of therapy for all types of anemia. One unit of blood transfusion is known to increase the hemoglobin level by 1g/dl and hematocrit by 3%. This study aims to analyze the mean increment in hemoglobin and hematocrit levels after 1-unit of blood transfusion in a tertiary care hospital. Materials and Methods: A retrospective study was done. 133 patients with 1-unit of blood transfusion (whole blood or packed red blood cells)having pre and post-transfusion hemoglobin and hematocrit values were enrolled in the study. Results: Patients of all diagnoses, who received blood transfusion were enrolled, with the highest proportion (27.1%) in the age group 18-35 years. Male predominance was seen (57.1%) and a majority of the patients were on hemodialysis (57.9%). The most common blood group was B positive (30%) and 90.9% were Rh positive. 48 patients were transfused with whole blood and 85 were transfused with packed red blood cells. The mean increment in hemoglobin and hematocrit levels were 0.75 ± 2.21 and 2.47 ± 6.84 respectively. A significant increment in post-transfusion parameters was seen compared with pre-transfusion parameters (p <0.001). Conclusions: A mean increment in hemoglobin and hematocrit level was seen in patients after transfusion. However, the value of the increment is low in our study as compared to the literature. This may be due to varied reasons, ranging from a history of chronic disease, acute bleeding, the volume of other fluids administered, and the characteristics of the donor.

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Audit of clinical use of red blood cells in a tertiary care setting: An algorithmic approach!

Cited by 6 publications

References 0 publications

Assessment of Blood Transfusion Utilization and Patient Outcomes at Yekatit-12 Hospital, Addis Ababa, Ethiopia

Assessment of Blood Transfusion Utilization and Patient Outcomes at Yekatit-12 Hospital, Addis Ababa, Ethiopia

Assessment of recipients’ characteristics, transfusion appropriateness, and utilization pattern of blood and blood products in Jimma Medical Center, Jimma, Ethiopia

Increment in hemoglobin and hematocrit levels after blood transfusion in a tertiary care hospital

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