Abstract
BACKGROUND: Patient blood management (PBM) programs can reduce unnecessary transfusions, but the optimal methods used to achieve this effect are unclear. We tested the hypothesis that encouraging single-unit red blood cell (RBC) transfusions in stable patients would have a greater impact on blood use than compliance with a specific hemoglobin (Hb) transfusion trigger alone. STUDY DESIGN AND METHODS: We analyzed blood utilization data at three community hospitals without previous PBM efforts before and after implementing a PBM program. Data were analyzed at monthly intervals to determine the relative impact of a "Why give 2 when 1 will do?" campaign promoting single-unit RBC transfusions and simultaneous efforts to promote evidence-based Hb triggers of 7 or 8 g/dL. Univariate and multivariate analyses were used to identify independent effects of these two interventions on overall RBC utilization. RESULTS: Univariate analysis revealed that both the increase in single-unit transfusions (from 38.0% to 70.9%; p<0.0001) and the decrease in RBC orders with an Hb trigger of at least 8 g/dL (from 45.7% to 25.0%; p<0.0001) were associated with decreasing RBC utilization. Multivariate analysis showed that the increase in single-unit transfusions was an independent predictor of decreased RBC utilization, but the Hb triggers of both 7 and 8 g/dL were not. Overall, our PBM efforts decreased RBC utilization from 0.254 to 0.185 units/patient (27.2%) across all three hospitals (p=0.0009). CONCLUSIONS: A campaign promoting single-unit RBC transfusions had a greater impact on RBC utilization than did encouraging a restrictive transfusion trigger.
| Original language | English (US) |
|---|---|
| Journal | Transfusion |
| DOIs | |
| State | Accepted/In press - 2017 |
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ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Hematology
Cite this
Single-unit transfusions and hemoglobin trigger : Relative impact on red cell utilization. / Yang, William W.; Thakkar, Rajiv N.; Gehrie, Eric; Chen, Weiyun; Frank, Steven Mark.
In: Transfusion, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Single-unit transfusions and hemoglobin trigger
T2 - Relative impact on red cell utilization
AU - Yang, William W.
AU - Thakkar, Rajiv N.
AU - Gehrie, Eric
AU - Chen, Weiyun
AU - Frank, Steven Mark
PY - 2017
Y1 - 2017
N2 - BACKGROUND: Patient blood management (PBM) programs can reduce unnecessary transfusions, but the optimal methods used to achieve this effect are unclear. We tested the hypothesis that encouraging single-unit red blood cell (RBC) transfusions in stable patients would have a greater impact on blood use than compliance with a specific hemoglobin (Hb) transfusion trigger alone. STUDY DESIGN AND METHODS: We analyzed blood utilization data at three community hospitals without previous PBM efforts before and after implementing a PBM program. Data were analyzed at monthly intervals to determine the relative impact of a "Why give 2 when 1 will do?" campaign promoting single-unit RBC transfusions and simultaneous efforts to promote evidence-based Hb triggers of 7 or 8 g/dL. Univariate and multivariate analyses were used to identify independent effects of these two interventions on overall RBC utilization. RESULTS: Univariate analysis revealed that both the increase in single-unit transfusions (from 38.0% to 70.9%; p<0.0001) and the decrease in RBC orders with an Hb trigger of at least 8 g/dL (from 45.7% to 25.0%; p<0.0001) were associated with decreasing RBC utilization. Multivariate analysis showed that the increase in single-unit transfusions was an independent predictor of decreased RBC utilization, but the Hb triggers of both 7 and 8 g/dL were not. Overall, our PBM efforts decreased RBC utilization from 0.254 to 0.185 units/patient (27.2%) across all three hospitals (p=0.0009). CONCLUSIONS: A campaign promoting single-unit RBC transfusions had a greater impact on RBC utilization than did encouraging a restrictive transfusion trigger.
AB - BACKGROUND: Patient blood management (PBM) programs can reduce unnecessary transfusions, but the optimal methods used to achieve this effect are unclear. We tested the hypothesis that encouraging single-unit red blood cell (RBC) transfusions in stable patients would have a greater impact on blood use than compliance with a specific hemoglobin (Hb) transfusion trigger alone. STUDY DESIGN AND METHODS: We analyzed blood utilization data at three community hospitals without previous PBM efforts before and after implementing a PBM program. Data were analyzed at monthly intervals to determine the relative impact of a "Why give 2 when 1 will do?" campaign promoting single-unit RBC transfusions and simultaneous efforts to promote evidence-based Hb triggers of 7 or 8 g/dL. Univariate and multivariate analyses were used to identify independent effects of these two interventions on overall RBC utilization. RESULTS: Univariate analysis revealed that both the increase in single-unit transfusions (from 38.0% to 70.9%; p<0.0001) and the decrease in RBC orders with an Hb trigger of at least 8 g/dL (from 45.7% to 25.0%; p<0.0001) were associated with decreasing RBC utilization. Multivariate analysis showed that the increase in single-unit transfusions was an independent predictor of decreased RBC utilization, but the Hb triggers of both 7 and 8 g/dL were not. Overall, our PBM efforts decreased RBC utilization from 0.254 to 0.185 units/patient (27.2%) across all three hospitals (p=0.0009). CONCLUSIONS: A campaign promoting single-unit RBC transfusions had a greater impact on RBC utilization than did encouraging a restrictive transfusion trigger.
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UR - http://www.scopus.com/inward/citedby.url?scp=85013053987&partnerID=8YFLogxK
U2 - 10.1111/trf.14000
DO - 10.1111/trf.14000
M3 - Article
C2 - 28164305
AN - SCOPUS:85013053987
JO - Transfusion
JF - Transfusion
SN - 0041-1132
ER -