Evaluation of the consumption of blood products after the patient blood management implementation in a tertiary referral hospital within five consecutive years

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Abstract: BACKGROUND AND AIMS: Patient blood management (PBM) is a multimodal scheme with several principles in the perioperative period which improves the outcome for patients. We prospectively evaluated the blood consumption situation during and after the years of implementation of PBM. METHODS: A 5 years’ prospective cross-sectional study was conducted between May 2016 and May 2020 in a tertiary referral hospital (Shahid Lavasani Hospital, Tehran, Iran). The outcome includes utilization rate of blood and its components (red blood cell [RBC], plasma and platelet [PLT]), transfused units per active hospital and intensive care unit (ICU) bed, the cross-match to transfusion ratio, transfusion index (TI), were evaluated before and after PBM implementation. The data were analyzed by the SPSS version 21. One-way repeated measures ANOVA and Friedman test were used. RESULTS: During 5 consecutive years, 6290 patients needed blood transfusions and entered to PBM protocol after their consent. Consumption of whole blood ceased in the initial year following PBM establishment. In 2017, RBC product usage (including whole blood and RBCs) decreased by 14.1% compared to 2016. This trend continued with further declines in 2018 (71.22%), 2019 (65.2%), and 2020 (59.10%) compared to 2016 (P < 0.001). The reduction in the number of plasma transfused over time was statistically significant (P < 0.001), as was the decrease in PLT transfusions (P < 0.001). RBC usage per active hospital bed per year declined from 22.83 to 3.61, and the TI showed a significant decrease. The highest RBC usage was observed in surgical departments during this period. RBC utilization per bed in the ICU was 57.7 in 2017, 25 in 2018, 22.7 in 2019, and 11.3 in 2020. CONCLUSION: With the implementation of the PBM program, the consumption of blood products in the hospital gradually decreased. The initial reductions in blood product consumption were observed in whole blood, plasma, and then RBCs.