Life, death, and the risk of transfusion: a university hospital experience

Frequently one encounters donor recruitment statements like ". . . about 90 percent of American adults will need at least one blood transfusion in the course of a lifetime." To assess the validity of such statements, the lifetime transfusion rate of patients dying in our tertiary-care hospital was determined. It would be expected that patients dying in a tertiary-care, Level 1 trauma center university hospital would have one of the highest transfusion rates.

A retrospective review of blood bank and electronic clinical records was conducted for all patients who expired at our institution from January 1, 2004, through December 31, 2004. Stillborn infants were excluded from analysis. The rate of transfusion was stratified by age and sex.

A total of 906 patients expired in 2004 at our institution. Of these, 35 were excluded (stillborn infants), leaving 871 patients for analysis. After review of blood bank records, 591 patients received blood products (67.9%). An additional 27 patients (3.1%) had a possible transfusion at another institution as the clinical record indicated complex surgical history. Only 253 patients (29.0%) did not have a documented transfusion event. Individuals who died before the age of 31 had the highest rates of transfusion (p < 0.001, Fisher's exact test, two-sided).

The majority of patients who expire at our institution have a history of transfusion (67.9%-71.0%). Patients who die before the age of 31 have the highest rate of transfusion.