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Abstract
Background
In support of safe and appropriate utilization of blood products, the Korean Ministry of Health and Welfare and the Korean Society of Blood Transfusion developed transfusion guidelines in 2009. We evaluated the appropriateness of blood transfusions on the basis of these proposed guidelines.
Methods
We investigated the awareness of the 2009 proposed guidelines and the transfusion guidelines currently in use through a questionnaire administered to the physicians of a tertiary care hospital. We provided the 2009 proposed transfusion guidelines through summarized pop-ups for each blood product that appeared in the hospital information system whenever a physician ordered blood products, and promoted the guidelines by posting it on the bulletin board and the hospital information system for one month. Evaluation of the appropriateness of blood transfusion was conducted by reviewing the medical records of patients who were transfused within one month before and one month after the promotion. Further, we also examined the rates of blood wastage and return.
Results
Rates of appropriately transfused blood products changed from 29.4% to 33.1% for red blood cells, from 16.9% to 68.9% for platelets, and from 54.8% to 33.3% for fresh frozen plasma. The decreased appropriate transfusion rate of fresh frozen plasma might be due to the small number of transfusions performed during the short study period. The rates of blood wastage and return decreased from 1.77% to 1.21% and from 3.91% to 3.00%, respectively.
Figures and Tables
Table 1
Appropriate transfusion rates of red blood cells, platelet concentrates, and fresh-frozen plasma
P<0.05 was considered statistically significant.
*Appropriate transfusion rate: Number of appropriate transfusions/Total number of transfusions ×100 (%).
†Statistical significance of the difference between appropriate transfusion rates before and after promoting the 2009 proposed transfusion guidelines was analyzed by the chi-square test.
Abbreviations: RBC, red blood cell; PC, platelet concentrate; FFP, fresh frozen plasma; No., number.
Table 2
Hemoglobin level, platelet count, and prothrombin time (international normalized ratio) at the time of transfusion order
Table 3
Appropriate transfusion rates of blood products according to clinical departments
*Appropriate transfusion rate: Number of appropriate transfusions/Total number of transfusions ×100 (%).
Abbreviations: RBC, red blood cell; PLT, platelet; FFP, fresh frozen plasma; PT, prothrombin time; IMO, Internal Medicine Division of Hematology/Medical Oncology; IMC, Internal Medicine Division of Cardiology; IMP, Internal Medicine Division of Pulmonology; IMG, Internal Medicine Division of Gastroenterology; IMN, Internal Medicine Division of Nephrology; IME, Internal Medicine Division of Endocrinology; IMF, Internal Medicine Division of Infectious Disease; NR, Neurology; PED, Pediatrics; GS, General Surgery; OS, Orthosurgery; PS, Plastic Surgery; CS, Chest Surgery; NS, Neurosurgery; URO, Urology; OB, Obstetrics & Gynecology; ER, Emergency Medicine.
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