The physician compliance of red blood cell transfusion by computerized transfusion decision support system

Abstract

“When should we trigger a transfusion?” is always a critical question between the patient’s benefits and risks in red blood cell (RBC) transfusion. A computerized transfusion decision support system (CTDSS) has been used since September 2004 in an academic medical center with 1400 beds. In this study, the factors affecting RBC transfusion were investigated. In total 20,551 RBC-transfusion episodes between January and December 2008 were reviewed. The nearest hemoglobin concentration before transfusion is defined as the transfusion trigger. The physician compliance, the factors associated with the transfusion triggers and posttransfusion hemoglobin increment were investigated. The physician compliance is 83.1%. The transfusion trigger is 8.32±1.84 (mean±standard deviation) g/dL. The transfusion triggers are statistically significant in terms of both different order sources and disease types (p<0.05).The posttransfusion hemoglobin level increased in two-thirds of the episodes. The percentages of hemoglobin increments after transfusion are dependent on the transfusion triggers. Appropriate transfusion practice may reduce the overuse of blood components and improve transfusion quality. CTDSS should be more powerful to intervene in the appropriateness of transfusion practice.

Keywords

• Computerized transfusion decision support
• Physician compliance
• Red blood cell (RBC) transfusion
• Transfusion indication
• Transfusion triggers