Evaluation of fresh frozen plasma usage at Tezpur Medical College and Hospital: A two-year study

Abstract

Background: Rational usage of blood components is important to ensure their availability to needy patients and to avoid unnecessary risk. Despite available guidelines, improvement in quality control, and standardization about the use of fresh frozen plasma (FFP), many studies around the world show a high frequency of its inappropriate use. Aims and Objectives: (i) To evaluate the pattern of FFP usage in our hospital and to categorize usage as appropriate or inappropriate based on FFP transfusion guidelines. (ii) To evaluate the effectiveness of FFP transfusion based on pre- and post-transfusion international normalized ratio (INR) values by calculating P-value using a paired t-test. Materials and Methods: This retrospective observational study was done by retrieving requisition forms of all the patients who received FFP transfusion in Tezpur Medical College, Tezpur, Assam, during the period of 2 years (November 01, 2020–October 31, 2022). Patients who received other blood products along with FFP were excluded from this study. Results: 1420 units of FFP were supplied to 850 patients during the study period of which 64% went to males. The most common age group receiving FFP was 30–39 years (28%). The most common indication for FFP was liver disease (33%). Appropriate usage was found in 74% of episodes and inappropriate usage in 26% of episodes. Statistically significant improvement was seen in post-transfusion INR when usage was appropriate (P < 0.001). Conclusion: The study highlighted the pattern of FFP usage in various clinical settings. Regular screening of requisition forms for proper guidelines-based indications, administrative interventions, and meetings of the hospital blood transfusion committee for education and sensitization of medical staff will go a long way in ensuring appropriate usage and good transfusion practice.