CLINICAL CHARACTERISTICS OF BLOOD TRANSFUSION IN GERIATRIC PATIENTS

In the presented study, the etiology was defined in geriatric patients who received transfusions with erythrocyte suspension due to anemia; the amount of transfusion was investigated and practical systems and methods to prevent the overuse of transfusions were developed. A retrospective patient records analysis was performed for a total of 328 patients aged ≥65 who received transfusions for any reason between July 2015 and 2018 at Sakarya Research and Training Hospital. Laboratory data at initial presentation, number of erythrocyte transfusions (NES), and total volume of erythrocyte suspension transfusions (TNES) performed during all admissions over the study period were recorded. Also recorded were the demographic data, concurrent conditions, and laboratory values. Patients were divided into two groups based on their age and hemoglobin levels. Age group A1 consisted of patients between 65 and 75 years of age (inclusive), while age group A2 consisted of patients over 75 years of age (exclusive). Based on the hemoglobin levels, the patients were identified as those with a hemoglobin <8 g/dl severe anemia (group H1), hemoglobin level ranging 8-9,5 g/dl moderate anemia (H2), and hemoglobin >9,5 g/dl - mild anemia (H3). The amount of transfusion and etiological factors responsible for anemia were examined. With respect to the incidence of iron deficiency, volume of transfused erythrocyte suspensions (ES), and total number of erythrocyte suspensions (TNES) were significantly higher in the H1 group, compared to the H2 group (p:0.012 and p:0.001, respectively). Comparing H2 and H3 groups, in terms of B12 deficiency, ES, and TNES were significantly higher in the H3 group than in the H2 group (p:.0001, p:.001, p:.001, respectively). In our study, transfusion indications in patients between 65 and 75 years of age and patients aged over 75 years differed significantly in terms of cardiac conditions and hypertension. The age groups were not significantly different in terms of transfusions performed for gastrointestinal bleeding. Also, the gender distribution across these two age groups was well balanced. No significant differences were noted related either to the age or to comorbid conditions between two groups. The higher average NES and TNES values in Group A2 (> 75 years) compared to Group A1 (65-75 y) were attributed to the need for achieving cardiovascular hemodynamic stability, and to the reduced tolerance of anemia due to accompanying comorbid conditions. Despite a wide array of etiological factors in anemic geriatric patients requiring transfusions, it is of utmost importance to develop a management plan for the underlying cause of anemia in order to reduce the indications for repeated transfusions. The anemia threshold for identifying the need for transfusion should be individualized based on the physiological status of each case.