Frequency and Outcomes of Blood Products Transfusion Across Procedures and Clinical Conditions Warranting Inpatient Care: An Analysis of the 2004 Healthcare Cost and Utilization Project Nationwide Inpatient Sample Database

Morton, John M.; Anastassopoulos, Kathryn; Patel, Snehal; Lerner, Jason; Ryan, Kellie; Goss, Thomas F.; Dodd, Sheri

doi:10.1177/1062860610366159

Cited by 67 publications

(55 citation statements)

References 19 publications

(25 reference statements)

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“…The macroeconomic dimension of this problem was alluded to in a retrospective cohort study by the American College of Medical Quality [58]. The investigators looked at all 38.7 million hospitalizations in the U.S. in 2004 to assess inhospital outcomes associated with blood transfusion.…”

Section: Adverse Transfusion Outcomementioning

confidence: 99%

Five Drivers Shifting the Paradigm from Product-Focused Transfusion Practice to Patient Blood Management

2011

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The objective of this paper is to introduce clinicians and health care professionals to the concept of patient blood management (PBM) and to explain the difference between PBM and the concept of "appropriate use" of blood products. The five reasons why modern health systems need to shift from product-focused transfusion practice to PBM are also presented. These are: the aging population with a leveraged demand for blood products opposed to a shrinking donor base; the growing awareness that transfusion is a complex service involving many different cost centers within a hospital and representing a multiple of the blood product cost; the continuous effort to protect blood pools from known, new, or re-emerging pathogens while facing uncertainty over their potentially long silent carrier states; the emerging evidence that transfusion is an independent risk factor for adverse outcomes; and finally, a lack of evidence for benefit of transfusion for the vast majority of recipients. The Oncologist 2011;16(suppl 3):3-11

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Section: Adverse Transfusion Outcomementioning

confidence: 99%

Five Drivers Shifting the Paradigm from Product-Focused Transfusion Practice to Patient Blood Management

2011

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“…Transfusion triggers based on arbitrary indications lead to the misuse and overutilization of blood products [1], which unnecessarily places pa-tients at risk for complications. Studies from various countries and medical disciplines independently associated liberal transfusion practices with adverse patient outcomes, longer hospital stay, and inefficient economics [2,3].…”

Section: Introductionmentioning

confidence: 99%

The Global Developments in Transfusion Replacements and Patient Blood Management

Yang

Kim

2017

KJBT

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Blood transfusions were once believed to the most potent and cost-effective method of improving patients' survival outcomes, but accumulating evidence over the past thirty years strongly suggests allogeneic transfusions as independent prognosticators of complications, prolonged hospital stay, and higher costs. A growing body of health care providers in Korea and throughout the world recognize a causal relationship between these adverse outcomes with liberal transfusion policies and call for a universal paradigm shift regarding the management of blood. Currently, the most promising contender is Patient Blood Management (PBM), which has been found to improve patient outcomes by conserving or optimizing the patient's own blood and physiologic reserves and advocating for restrictive transfusion policies. PBM incorporates evidence-based transfusion replacements to address anemia, bleeding, and blood disorders. These various methods-such as intravenous iron, erythropoiesis stimulating agents, coagulating factors, and topical hemostatic agents-are gaining recognition because of their ability to preclude the need for allogenic transfusions while effectively managing the patient's blood. (Korean J Blood Transfus 2017;28:103-112)

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“…Blood transfusion has been said to be one of five most overused procedures in medicine and the most frequently performed therapeutic procedure [8][9][10]. While the overall use of red cells is decreasing in many countries, large audits show much inappropriate use (up to 50%) [11] and considerable inter-institutional variability (ranging from 7.5 to 98 percent transfusion rates in cardiac surgery) [12].…”

Section: Introductionmentioning

confidence: 99%

Transfusion Medicine: Time for a Change: Patient Blood Management and the Ontario ONTraC Program

Freedman¹

2016

J Perioper Crit Intensive Care Nurs

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Despite increasing recognition of the potential adverse effects of blood transfusion there is evidence that the procedure is over-utilized and often inappropriately and unnecessarily administered. Patient Blood Management (PBM) is a recent world-wide initiative to optimize transfusion therapy by employing preoperative and perioperative maneuvers and alternatives to avoid unnecessary blood transfusion. These approaches are, however, not restricted to the surgical setting, but may be applied whenever transfusion is contemplated. A key component of PBM is the appropriate management of anemia, a prime determinant of transfusion. Another is tolerance of anemia through the use of restrictive transfusion thresholds for transfusion and of a single unit at a time policy. Among a number of options at surgery, antifibrinolytics have proven effective at reducing blood loss and transfusion. Burgeoning literature demonstrates that PBM (also known as Blood Conservation or as 'Bloodless Medicine/Surgery') is costeffective while improving patient outcomes and conserving the blood supply. Data from the ONTraC program in Ontario are described herein to illustrate the effectiveness of PBM approaches.

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Frequency and Outcomes of Blood Products Transfusion Across Procedures and Clinical Conditions Warranting Inpatient Care: An Analysis of the 2004 Healthcare Cost and Utilization Project Nationwide Inpatient Sample Database

Cited by 67 publications

References 19 publications

Five Drivers Shifting the Paradigm from Product-Focused Transfusion Practice to Patient Blood Management

Five Drivers Shifting the Paradigm from Product-Focused Transfusion Practice to Patient Blood Management

The Global Developments in Transfusion Replacements and Patient Blood Management

Transfusion Medicine: Time for a Change: Patient Blood Management and the Ontario ONTraC Program

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