Appropriateness of platelet, fresh frozen plasma and cryoprecipitate transfusion in New South Wales public hospitals

• Published in: Medical journal of Australia 2003-02, Vol.178 (3), p.117-121
• Main Authors: Schofield, William N, Rubin, George L, Dean, Mark G
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Component Transfusion - statistics & numerical data; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Factor VIII; Fibrinogen; Forms and Records Control; Hematologic diseases; Hospital Records - standards; Hospital Records - statistics & numerical data; Hospitals, Public - statistics & numerical data; Humans; Medical Audit; Medical sciences; New South Wales; Patient Selection; Plasma; Platelet Transfusion - statistics & numerical data; Quality Assurance, Health Care; Retrospective Studies; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0025-729X; 1326-5377
• DOI: 10.5694/j.1326-5377.2003.tb05101.x

Objectives: To estimate the appropriateness of transfusions of platelets, fresh frozen plasma (FFP) and cryoprecipitate using National Health and Medical Research Council and Australasian Society for Blood Transfusion guidelines (NHMRC/ASBT 2002). Design and setting: Three separate retrospective surveys of medical records from 1 January to 31 August 2000 (1147 transfused patients) from 14 hospitals selected randomly from all public hospitals that use these blood products in New South Wales: five tertiary referral, five major metropolitan, and four major rural (base) hospitals. Main outcome measures: Proportion of potentially inappropriate transfusions. Results: 33% (136/414) of platelet, 37% (248/669) of FFP and 62% (37/60) of cryoprecipitate transfusions were assessed as inappropriate. By hospital type, 29% (75/259) of platelet transfusions were inappropriate at tertiary referral hospitals, 51% (40/78) at major urban hospitals, and 27% (21/79) at major rural hospitals. For FFP, 36% (112/313), 37% (80/216) and 39% (55/140) were inappropriate for referral, urban and rural hospitals, respectively. Cryoprecipitate was used almost exclusively at tertiary referral hospitals. Conclusions: In terms of the NHMRC/ASBT guidelines on use of blood products, there is considerable inappropriate transfusion of platelets, FFP and cryoprecipitate in NSW public hospitals.