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Evaluation of Platelet Transfusions Practice: Results of at a Tertiary Healthcare Center in Turkey

Background: Platelet transfusion is an effective method used to prevent and treat bleeding in thrombocyto-penic patients. The impact of platelet transfusion without respecting the ABO compatibility on platelet transfusion refractoriness is debated. We aimed to evaluate platelet transfusions practice at our tertiary care hospital.Materials and Methods: We analyzed 849 hematology-oncology patients who underwent platelet transfu-sion at Dokuz Eylül University Hospital between January 2014 and December 2020. Case under the age of 18 were excluded from the study. We retrospectively assessed the demographic data of selected cases, the types of transfusion products employed, and patients’ laboratory parameters. Results: Hematology-oncology patients accounted for 44.6% (n=849) of the transfusions. Much of the remainder is used in the emergency department 11.7% (n=224) and intensive care 6.8% (n=131). Eight hundred and forty-nine hemato-oncological patients were retrospectively identified between 2014 and 2020. The median age was 60 (18–91) years, with 44.6% women. ABO-identical platelet transfusions were 93.6%. Eighty-one percent of platelets were transfused to patients with counts < 25 × 10^6 µL. Post transfu-sion the next day, platelet count increment <10 × 10^6 µL was 31.6%, 37.5%, 30.0% for ABO compatible, ABO major incompatible, and ABO minor incompatible, respectively.Conclusions: We conclude that platelet transfusions should always be made to only ABO identical platelets whenever possible. As with every blood product transfusion, comprehensive and practical national policies should be developed based on international guidelines for causing minimum side effects and maximum efficacy for platelet transfusion.

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A model of cost-outcome analysis for assistive technology

During the CERTAIN study (research carried out in 1994–96 within the Technology Initiative for Disabled and Elderly (TIDE) programme of the European Union), a number of real life case studies of provision of assistive technology to disabled persons were investigated in order to assess the applicability of socio-economic principles, methods and techniques already available from Health Care Technology Assessment studies. A retrospective study on cost, effectiveness and utility resulting from the implementation of assistive technology was carried out over a sample of disabled persons who had adopted technical aids before the start of the project. The sample was selected in such a way to include different pathologies (steady or progressive), impairments, ages, technology and social environment. Each case was described by considering all clinical, technical and social aspects; a common structure for case reporting was developed and tested; attempts were carried out to apply and refine concept and tools derived from health technology assessment studies; on the grounds of such experience a decision support model was elaborated for the choice between different alternatives in order to maximize the client's quality of life while making efficient use of scarce resources. A computer implementation of such a model was also developed, along with a mathematical structure of cost analysis. Within a national research programme such findings were further exploited, leading to the development of a prototype cost-outcome instrument designed for use in clinical practice in the provision of assistive technology to individual cases.

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