Service Member Completion of Laboratory Follow-Up After Emergency Transfusion With Freshly Collected Blood Products.

Abstract

Transfusion of freshly collected blood products (FCBP) is sometimes necessary to save service member (SM) lives in austere deployed environments. Recipients of FCBPs are administratively tracked and offered serial serologic testing via the Armed Services Blood Program "Blood Look Back" (BLB) program to assure early detection of post-transfusion infections. This study evaluates demographic and clinical features influencing SM completion of recommended BLB laboratory follow-up after transfusion with FCBPs. Using BLB programmatic data, a retrospective cohort study was performed examining U.S. SM transfusion recipients of FCBPs from June 1, 2006, through December 31, 2012. Multivariate logistic regression was used to examine clinical and demographic factors influencing completion of BLB recommended follow-up. Of eligible subjects, 69% (n = 778) completed 12-month recommended BLB follow-up. As compared to other services, U.S. soldiers demonstrated greatest compliance with BLB recommendations with 71.7% completing recommended follow-up. As compared to the Army, SMs from the Air Force (odds ratio [OR] = 0.35, 95% confidence interval [CI] = 0.15-0.85), Marine Corps (OR = 0.51, 95% CI = 0.37-0.71), and Navy (OR = 0.29, 95% CI = 0.11-0.74) were less likely to complete recommended follow-up; however, differences in follow-up among the services attenuated over time. Neither the type of FCBP (platelets versus whole blood) nor the volume of FCBP transfused significantly altered SM likelihood of competing recommended follow-up. More than 2 out of 3 SMs completed recommended 12-month BLB follow-up after transfusion with FCBPs with greater compliance in Army SMs compared to other services. Programmatic changes implemented by the BLB program were temporally associated with increased SM compliance with recommended follow-up as well as reduction of disparities in follow-up observed between the services.