Audit of clinical use of red blood cells in a tertiary care setting: An algorithmic approach!

Abstract

Objective: There have been quite a few publications on audit of clinical use of blood components. However, there is paucity of studies on red blood cell (RBC) clinical use. Therefore, a study was designed to determine the appropriate clinical use of RBC in various departments in a tertiary care setting. Materials and Methods: It was a prospective observational study conducted from January 2017 to April 2017 in a large tertiary care hospital in north India. The study population included all consecutive admitted patients who received RBC transfusion during the study period. Patients undergoing RBC transfusions the in operation theater were excluded. An algorithmic approach was used which analyzed the “appropriateness” on the basis of hemoglobin thresholds, symptoms in patient, comorbidities, and imminent blood loss in a sequential manner. Results and Discussion: Of a total of 1024 transfusions, 924 (90.02%) episodes were appropriate. This was higher than the previous published reports because of algorithmic approach, higher hemoglobin threshold (8 g%), and possibly better informed physicians in tertiary care setting. Conclusion: There were a high percentage of appropriate RBC transfusions in large tertiary care settings.