Transfusion medicine
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Transfusion medicine · Dec 2009
Multicenter StudyThe EASTR Study: indications for transfusion and estimates of transfusion recipient numbers in hospitals supplied by the National Blood Service.
This study provides data on National Blood Service (NBS) red blood cell (RBC, n = 9142), platelet (PLT, n = 4232) and fresh frozen plasma (FFP, n = 3584) recipients independently sampled by monthly quota from 29 representative hospitals over 12 months in 2001-2002. Hospitals were stratified by size according to total yearly RBC issues. Transfusion indications were chosen from diagnostic and procedural codes, and recipients grouped into Epidemiology and Survival of Transfusion Recipients Case-mix Groups (E-CMGs). ⋯ PLT recipients: the main E-CMGs were haematology (27% of PLT recipients; including 9% lymphoma and 8% acute leukaemia), cardiac (17%), paediatrics (13%), hepatobiliary (10%) and digestive (9%). Back-weighting gave national estimates of 433 000 RBC, 57 500 FFP and 41 500 PLT recipients/year in England and North Wales, median age 69, 64 and 59 years, respectively. Digestive and hepatobiliary indications emerged as the top reason for transfusion in RBC and FFP recipients, and was also a frequent indication in PLT recipients.
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The objective of the study was to assess phlebotomy loss in renal medical in-patients in order to minimise an iatrogenic cause of anaemia. Phlebotomy has been shown to be a significant cause of iatrogenic blood loss in critical care. However, there has been limited research in patients with renal disease, at risk from anaemia. ⋯ Samples were taken for biochemistry (38%), FBC (36%), transfusion (13%) and others (13%). 46% of patients were transfused (mean 4.8 +/- 3.6 units). Blood loss was lower than in previous studies conducted in intensive care and general medicine but clinical staff should be aware of the cumulative blood loss from phlebotomy. Losses should be managed by optimising the frequency and volume of blood drawn for diagnostic laboratory tests.