Appropriateness of Blood Transfusion in the Department of Medicine, Phramongkutklao Hospital

Abstract

Background: The red blood cell transfusion is a useful management for an variable patient situation.The problem in blood transfusion practice is adverse effects, particularly transmitted dises, and shortage in its supply. Moreover, the blood transfusion practice is an important part of Hospital Accreditation (HA). Therefore it is necessary to develop clinical practice guideline for blood transfusion. Oblective: To determine appropriateness and inappropriateness or red blood cell transfusion in the Department of Medicine. Study design: Prospective observational study. Setting: Department of Medicine, Phramongkutkdao Hospital. Materials and Methods: The criteria of red cell transfusion was elaborated from guidelines of American College of Physicians and the College of American Pathologists, and consensus of staffs in Department of Medicine. Two hundred and forty red cell transfusions were analyzed by review within 24 24 hours of the transfusions. Consecutive transfusions were evaluated during October to December 2000. Results: Two hundred and forty red cell transfusion were used for 144 patients and total of red cell transfused were 416 units. Most patients received transfusions had multiple medical diseases. The appropriateness and inappropriateness of blood transfusion were 218 (90.84%) and 22 (9.16%), respectively. There was tendency of inappropriateness of blood transfusion in the group of one unit transfused than muliple units transfused. Conclusions: Our study identified the inappropriateness of red blood cell transfusions. Reduction of inappropriate rate of blood transtusion can save the expense and avoid adverse effects of transfusion. Guidelines for transfusion education of physicians and a monitoring system to ensure adherence to the guidelines, are required.