Transfusion
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Each year, approximately 5% of the invited blood donors is eventually deferred from donation because of low hemoglobin (Hb) levels. Estimating the risk of Hb deferral in blood donors can be helpful in the management of the donation program. We developed and validated a prediction model for Hb deferral in whole blood donors, separately for men and women. ⋯ Using a limited number of easy-to-measure characteristics enables a good prediction of Hb deferral risk in whole blood donors. The prediction models may guide the decision which donors to invite for a next donation and for which donors the invitation should be postponed. Potentially, this could decrease the number of Hb deferrals in blood donors.
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Multicenter Study
Patient blood transfusion management: discharge hemoglobin level as a surrogate marker for red blood cell utilization appropriateness.
Blood transfusion management strategies minimize transfusion-associated risks, enhance outcomes, and reduce costs. We explored an association of discharge hemoglobin (Hb) with pretransfusion Hb, transfusion indications, and red blood cell (RBC) transfusions. We stipulate that patients with discharge Hb concentrations greater than 10.0 g/dL, or even 9.0 g/dL, received excessive RBC transfusions. ⋯ In aggregate, overutilization exceeded 20%. At the focus hospital, approximately one-quarter of patients receiving transfusions had a Hb concentration greater than 10.0 g/dL at discharge. Transfused patients' discharge Hb concentration represents an effective indicator for retrospective monitoring of transfusion appropriateness. In light of the large number of patients receiving even number transfusions, reviewing Hb levels after transfusion of each RBC unit could reduce unnecessary transfusions. Retrospective review of discharge Hb data focuses providers on transfusion outcomes and affords an educational opportunity for blood utilization management.
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Monitoring of patients' vital sign values (VSVs) during hemotherapy may have an important role in the recognition and mitigation of transfusion-associated circulatory overload (TACO). Knowledge regarding VSVs and other patient characteristics in bedside-reported TACO or fluid challenge-suspected transfusion reactions (TACO/FC-STRs) is limited. ⋯ Trend monitoring of peritransfusion VSVs, especially blood pressures, may aid in the bedside recognition of TACO/FC-STRs. A subset of these patients may also present with febrile and/or inflammatory signs and symptoms.