Inpatient recipients of packed red blood cells in a university medical center in Poland in 2018–2019

Abstract

Background: Availability of epidemiologic data on recipients of packed red blood cells (RBCC) is crucial for demand planning and policy development in the blood supply and delivery system, as well as patient blood management (PBM). The obvious limitation of large databases is lack of specific clinical data. We aimed to assess inpatient recipients of RBCC in our institution in the years 2018–2019 to prepare a comprehensive institutional PBM program. Material and methods: We performed a retrospective analysis of all RBCC recipients in our institution between 1 January 2018 and 31 December 2019. Basic demographic and clinical data of patients who received RBCC were retrieved from hospital electronic health records. We calculated the percentage of hospitalizations with RBCC transfusion, average number of RBCC units transfused during single hospitalization in different hospital departments. Results: During the study period there were 1312 (1.41%) hospitalizations with RBCC transfusion. The median age of transfused patients (1 hospitalization in a hospital department = 1 patient) was 62 (IQR 45–71) years. Among these patients there were 528 (40.2%) men and 784 (59.8%) women. Among patients who were transfused with at least a single RBCC unit, 33.8% were diagnosed with malignancy and 20.3% with non-malignant gastrointestinal disease or gastrointestinal bleeding. Single RBCC transfusions accounted for 85.4% of all transfusions. RBCC unit were transfused most frequently in patients hospitalized in the intensive care unit (ICU) (44.6% of hospitalizations). In departments of Gastroenterology & Hepatology, ICU, Gastrointestinal Surgery, Gynecology & Obstetrics, 2749 units (68.9%) RBCCs were transfused. In the ICU and surgical departments (gastrointestinal, gynecology & obstetrics, neurosurgery) 53.5% of all RBCCs were transfused. Conclusions: The results show that more than half of RBCC recipients were patients with primary diagnosis of malignancy, non-malignant gastrointestinal disease, or gastrointestinal bleeding. RBCCs were most frequently transfused in patients hospitalized in the ICU. More than half of all RBCCs were transfused in patients hospitalized in the ICU and surgical departments. In the development phase of inpatient PBM program particular attention should be focused on the abovementioned groups of patients.