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Plasma transfusion practices: A multicentre electronic audit.

Aditi Khandelwal^1,2, Leigh Minuk³, Yang Liu⁴

¹Canadian Blood Services, Toronto, Ontario, Canada.

|September 14, 2022

Summary

This summary is machine-generated.

Most plasma transfusions are unnecessary or under-dosed, leading to potential harm and increased costs. This electronic audit highlights the need for improved transfusion practices in hospitals to ensure appropriate use of plasma products.

Keywords:

coagulation factor therapy haemostasis plasma transfusion

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Area of Science:

Transfusion Medicine
Hematology
Clinical Audit

Background:

Plasma transfusions are common for bleeding patients but often administered without clear indication.
Previous chart audits suggest up to 50% of plasma transfusions are unnecessary.
Unnecessary transfusions lead to avoidable complications and healthcare costs.

Purpose of the Study:

To determine the proportion of plasma transfusions given without a valid indication.
To assess the frequency of sub-therapeutic dosing in plasma transfusions.
To evaluate the utility of electronic audits for assessing transfusion practices.

Main Methods:

A multicentre electronic audit of adult inpatient plasma transfusions in 2017.
Data extracted from electronic health records, lab systems, and administrative databases.
Defined criteria for inappropriate transfusion (e.g., INR < 1.5 without significant bleeding) and sub-therapeutic dose (≤2 units).

Main Results:

Over 11,000 units of plasma transfused across five academic sites.
77.7% of plasma transfusions were either outside indications or under-dosed.
34.8% of orders lacked indication, and 70.7% of transfusions were sub-therapeutic.

Conclusions:

The majority of plasma transfusions are suboptimal, indicating a need for practice improvement.
Hospital culture appears to influence transfusion practices.
Electronic audits are a practical and potentially cost-effective method for evaluating transfusion appropriateness.