[Analysis of factors determining transfusion albumin usage in different prefectures]

According to recent changes in the prevalence of diseases and innovations in medical technology, the requirement for blood products and blood plasma fractions has increased dramatically in Japan. The difficulty in meeting demands is making resort to importation of blood products from other countries necessary. Hokkaido, the prefecture with the highest consumption of blood products, uses 10 times more albumin than that of the lowest blood consumer, Kouchi, This study analyzed the factors, underlying these differences in albumin consumption between prefectures, to provide pointers to meet most appropriately blood products utilization.

The questionnaire regarding management of blood products, total amount of consumption of blood products, sex, age and diagnosis of patients, examinations of albumin concentrations in the blood before and after the use of albumin product, operations etc. was distributed to 8,334 medical institutes, collected and analyzed. We divided all 47 prefectures into 4 groups, according to albumin consumption amount, and compared factors for 45-84 year old patients.

The results showed the proportion of patients with the top 20 diseases to be significantly higher in the highest albumin consumer group than in the others. In addition, the percentage of non-examinations of albumin concentrations in the serum before and after the use of albumin products was significantly higher in the highest albumin consumer group. Furthermore, the concentrations of albumin in the serum both before and after their application were significantly higher in the highest albumin consumer group than in the others. There was no significant difference in bed usage among the groups. Comparison of the results for the 4 groups indicated that the use of albumin in cases of liver fibrosis, cirrhosis, hepatoma and gastric cancer may have a special impact on the total consumption of albumin per person. Albumin may be used in the highest albumin consumer group without sufficient consideration for the shortage of albumin products.

There are some factors causing difference in albumin consumption among prefectures, such as whether or not albumin concentrations in the blood are examined before and after the usage, The importance of adopting measures to assure appropriate consumption of albumin clearly needs to be emphasized.