An audit of appropriate use of blood products in adult patients in a Venezuelan general university hospital.

Abstract

To audit appropriate use of blood products in adult patients. A cross-sectional study with pre-set criteria. Ciudad Hospitalaria 'Dr. Enrique Tejera', the main public tertiary-care hospital in Valencia, Venezuela. We studied 700 adult patients from the Medicine, Surgery, Emergency and Obstetrics departments. Appropriate use of blood products. Seven hundred patients who had an average of 2.45 transfusions (95% confidence interval = 2.28-2.62) were studied. Prevalence of appropriate use was 51.3% for all departments. Prevalence by department was: 72% for Medicine, 36% for Surgery, 56% for Emergency, and 47% for Obstetrics. The average number of transfusions per subject in each department was: Medicine, 3.41; Surgery, 1.75; Obstetrics, 2.09; and Emergency: 2.81 (F-test: P=0.005). Using the department of Medicine as the reference group, it was found that the departments of Surgery, Emergency and Obstetrics had a higher 'risk' of inappropriate use of transfusions, showing odds ratios of 4.4, 1.38 and 2.79 respectively. The main conclusions of this study are: (i) the prevalence of the appropriate use of blood products was 51%; (ii) packed red cells and fresh frozen plasma were the blood products with the lowest prevalence of appropriate use; and (iii) none of the departments showed rates of appropriate use of transfusions greater than 80%, implying a higher cost in health care and putting patients at a higher risk for acquiring a transfusion-transmitted disease.