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Audit on the usage of plasma derived/recombinant coagulation factor concentrates at a German university hospital
J Strobel1, H Jörns, V Weisbach
1Department of Transfusion Medicine and Hemostaseology, Friedrich-Alexander-University Erlangen-Nuremberg, Germany. julian.strobel@uk-erlangen.de
Insights
This study audited plasma-derived/recombinant coagulation factor concentrate (PD/RCFC) usage in a German hospital. Few major diagnostic categories drive most transfusion costs, highlighting areas for improved hemotherapy management.
Area of Science:
- Transfusion Medicine
- Hematology
- Hospital Pharmacy
Background:
- Limited data exists on plasma-derived/recombinant coagulation factor concentrate (PD/RCFC) usage patterns across diagnostic categories.
- A comprehensive audit was conducted to analyze PD/RCFC and blood component utilization at a tertiary care teaching hospital.
Purpose of the Study:
- To analyze the usage of blood components and PD/RCFC in relation to major diagnostic categories (MDCs).
- To identify key diagnostic areas driving transfusion costs and resource allocation.
Main Methods:
- Retrospective analysis of all transfused blood components and PD/RCFC at a university hospital in 2006.
- Classification of transfused products by MDCs based on the International Classification of Diseases (ICD-10).
Main Results:
- Blood component usage significantly increased compared to 1994-1996 surveys.
- Antithrombin was the most frequently used PD/RCFC; Factor VIII concentrates incurred the highest costs.
- Specific MDCs (Pre, 17, 05) accounted for 80.5% of PD/RCFC transfusion costs.
Conclusions:
- This study provides novel combined data on blood component and PD/RCFC usage in a German university hospital.
- A small number of MDCs are responsible for the majority of transfusion therapy costs for both blood components and PD/RCFC.
- Enhancements in blood bank information software are recommended for detailed trend analysis in hemotherapy.
Background:
There is a lack of data on the usage of plasma derived/recombinant coagulation factor concentrates (PD/RCFC) regarding diagnostic categories. An audit of PD/RCFC and blood component usage at a tertiary care teaching hospital in northern Bavaria was conducted.
Study Design And Methods:
All blood components and PD/RCFC transfused at a university hospital (Erlangen, Germany) during the year 2006 were analysed. Transfused blood products were listed by major diagnostic categories (MDC) formed from principal diagnoses of recipients according to the International Classification of Diseases, tenth revision and German modification.
Results:
Blood component usage has markedly increased since last surveyed in 1994 through 1996. The diagnostic categories responsible for most transfusions have not changed since. Antithrombin is the PD/RCFC used most, whereas most money for PD/RCFC was spent on FVIII concentrates. Polytrauma patients need most fibrinogen, whereas most of FXIII is needed in patients with malignancies. Patients with prolonged artificial ventilation receive PCC most often. Altogether, three MDCs (Pre, 17, 05) accounted for 80·5% of costs created by PD/RCFC transfusion.
Conclusion:
This study provides for the first time combined data on blood component and PD/RCFC usage in a German university hospital. It shows that the MDCs responsible for most of the costs in transfusion therapy with blood components and with PD/RCFC are few, and are the same. At the same time, blood bank information software should be further improved in order to be able to identify new trends in hemotherapy in more detail.
