Volume 22, Issue 4 (Winter 2025)
bloodj 2025, 22(4): 305-315 |
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Ethics code: IR.IAU.KHUISF.REC.1398.108
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Chahardah Cherik Y, Javadzadeh Shahshahani H, Mortazavizadeh S. Audit of Red Blood Cell Transfusion Appropriateness at two Teaching Hospitals in Yazd: A Retrospective Study of Guideline Compliance. bloodj 2025; 22 (4) :305-315
URL: http://bloodjournal.ir/article-1-1599-en.html
URL: http://bloodjournal.ir/article-1-1599-en.html
Abstract: (173 Views)
A B S T R A C T
Background and Objectives
Red blood cell (RBC) transfusion is a life-saving intervention in modern medicine. However, inappropriate use remains common and may increase the risk of adverse events, prolong hospitalization, and raise healthcare costs. This study aimed to evaluate the indications for RBC transfusion in two teaching hospitals and assess their compliance with international guidelines.
Materials and Methods
In this cross-sectional retrospective study, we reviewed medical records of 201 hospitalized patients who received at least one unit of RBCs over a one-year period. Data collected included demographic characteristics, primary diagnoses , pretransfusion hemoglobin (Hb) levels, documented transfusion indications, and the number of units administered. Transfusion appropriateness was determined according to AABB and other internationally accepted guidelines. Data were analyzed using SPSS 22, with Chi‑square or ANOVA tests. A p-value<0.05 was considered statistically significant.
Results
The mean patient age was 56.94 ± 13.21 years; and 52.7% were male. Overall, 78.6% of transfusions were guideline‑compliant, while 21.4% were inappropriate. The most common indication was symptomatic anemia (22.9%), and the highest rate of inappropriate transfusion occurred among surgical patients (46.9%, p<0.001). A significant association was found between pretransfusion Hb level and inappropriate transfusion (p=0.01); notably, all transfusions at Hb >10 g/dL were inappropriate. The most frequently transfusion unit numbers was two.
Conclusions
Although most RBC transfusions were well-matched to established guidelines, substantial proportions were inappropriate, particularly for surgical patients and those with higher pretransfusion Hb levels. Implementation of patient blood management (PBM) strategies, targeted education and continuous monitoring can help improve blood product utilization and patient outcomes.
Background and Objectives
Red blood cell (RBC) transfusion is a life-saving intervention in modern medicine. However, inappropriate use remains common and may increase the risk of adverse events, prolong hospitalization, and raise healthcare costs. This study aimed to evaluate the indications for RBC transfusion in two teaching hospitals and assess their compliance with international guidelines.
Materials and Methods
In this cross-sectional retrospective study, we reviewed medical records of 201 hospitalized patients who received at least one unit of RBCs over a one-year period. Data collected included demographic characteristics, primary diagnoses , pretransfusion hemoglobin (Hb) levels, documented transfusion indications, and the number of units administered. Transfusion appropriateness was determined according to AABB and other internationally accepted guidelines. Data were analyzed using SPSS 22, with Chi‑square or ANOVA tests. A p-value<0.05 was considered statistically significant.
Results
The mean patient age was 56.94 ± 13.21 years; and 52.7% were male. Overall, 78.6% of transfusions were guideline‑compliant, while 21.4% were inappropriate. The most common indication was symptomatic anemia (22.9%), and the highest rate of inappropriate transfusion occurred among surgical patients (46.9%, p<0.001). A significant association was found between pretransfusion Hb level and inappropriate transfusion (p=0.01); notably, all transfusions at Hb >10 g/dL were inappropriate. The most frequently transfusion unit numbers was two.
Conclusions
Although most RBC transfusions were well-matched to established guidelines, substantial proportions were inappropriate, particularly for surgical patients and those with higher pretransfusion Hb levels. Implementation of patient blood management (PBM) strategies, targeted education and continuous monitoring can help improve blood product utilization and patient outcomes.
Type of Study: Research |
Subject:
Blood transfusion medicine
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