Where does blood go? Prospective observational study of red cell transfusion in north England

To collect population based information on transfusion of red blood cells.

Prospective observational study over 28 days.

Hospital blood banks in the north of England (population 2.9 million).

Indications for transfusion, number of units given, and the age and sex of transfusion recipients.

All patients who received a red cell transfusion during the study period. Data completed by hospital blood bank staff.

The destination of 9848 units was recorded (97% of expected blood use). In total 9774 units were transfused: 5047 (51.6%) units were given to medical patients, 3982 (40.7%) to surgical patients, and 612 (6.3%) to obstetric and gynaecology patients. Nearly half (49.3%) of all blood is given to female recipients, and the mean age of recipients of individual units was 62.7 years. The most common surgical indications for transfusion were total hip replacement (4.6% of all blood transfused) and coronary artery bypass grafting (4.1%). Haematological disorders accounted for 15.5% of use. Overall use was 4274 units per 100 000 population per year.

In the north east of England more than half of red cell units are transfused for medical indications. Demand for red cell transfusion increases with age. With anticipated changes in the age structure of the population the demand for blood will increase by 4.9% by 2008.