Evaluation of Appropriateness of Red Blood Cell Transfusions

Abstract

Background and Objectives: Red blood cells (RBC) transfusion is an important medical therapy in modern medicine. Blood is a scarce resource used in large numbers; therefore, it is very essential for its components to be used appropriately and judiciously. It is necessary to monitor, assess, and evaluate the existing trends and appropriateness of blood utilization. The establishment of criteria for blood transfusion and strict adherence to such criteria may be necessary to improve blood usage. The objective of this study was to understand the utilization pattern of RBC transfusions based on indications and to evaluate the appropriateness of RBC transfusion at a tertiary care oncology center. Methods: This was a prospective observational study conducted over a period of 4 months. A total of 4413 RBC transfusion events in 2012 adult oncology patients were analyzed for appropriateness as per institutional guidelines. Data were obtained from the blood requisitions, issue records of the Department of Transfusion Medicine and from the Electronic Medical Records of the patients. Results: Total of 83% of transfusion events were found to be appropriate with Anemia being the most common indication for RBC transfusion in medical and surgical oncology units. Appropriateness was significant (P < 0.05) in medical oncology as compared to surgical oncology units. Appropriateness was highest and statistically significant (P < 0.05) in operation theatres while inappropriateness was more and significant in the daycare facility (P < 0.05). Conclusion: Total 83% of RBC transfusions were found to be appropriate indicating that clinical practices of RBC transfusions in the hospital were rational with adherence to institutional guidelines.