[Suitability of red blood cell transfusion: a multicenter study]

Area of Science:

• Hematology
• Transfusion Medicine
• Clinical Practice Guidelines

Context:

• Red blood cell (RBC) transfusion practices require adherence to national guidelines.
• Assessing transfusion appropriateness is crucial for patient safety and resource management.
• Previous studies indicate variability in RBC transfusion practices.

Purpose:

• To evaluate the appropriateness of red blood cell (RBC) transfusions based on French national guidelines (2002).
• To analyze patient characteristics, transfusion parameters, and hemoglobin concentrations in relation to transfusion appropriateness.
• To identify factors contributing to inappropriate RBC transfusions.

Summary:

• A retrospective observational study analyzed 639 RBC transfusions across nine institutions.
• Physician assessments indicated 93% of pre-transfusion and 79% of discharge hemoglobin levels aligned with guidelines.
• Inappropriate transfusions were primarily linked to over-transfusion, with some transfusions deemed 'precocious' or excessive.

Impact:

• Findings suggest that while pre-transfusion triggers may be restrictive, target hemoglobin levels are liberal, leading to over-transfusion.
• Highlights the importance of physician judgment in determining transfusion necessity, especially in cases of asymptomatic anemia.
• Provides insights for refining RBC transfusion protocols to improve appropriateness and reduce unnecessary transfusions.