Blood transfusion raises many questions of safety and economics. We examined blood usage and its characteristics in patients taken care of by hospitalists, a group of physicians for whom there is a scarcity of published data. We also sought to determine if an educational intervention changed hospitalist transfusion practice patterns.
Hospitalist transfusion practices at a 550‐bed inner‐city community teaching hospital were assessed from November 1, 2006, to January 31, 2007, with a retrospective chart review of the first transfusion performed on each patient cared for by a hospitalist. Following a 2‐month educational intervention, hospitalist transfusion practices were reassessed from April 1, 2007, to June 30, 2007, and compared with the preeducation period. Patients who were on dialysis or were admitted from a clinic for transfusion were excluded. Data collected included age, sex, pretransfusion hemoglobin level, primary cause of anemia, primary reason for admission, and whether cardiac disease was present. Pre‐ and post‐education populations were compared using age, sex, and ICD‐9 codes extracted from the hospital billing database and subjected to statistical analysis.
Enrollment criteria for the study were met by 248 patients. The most common reasons for transfusion in the pre‐ and posteducation periods were anemia of chronic disease, followed by acute blood loss, chronic blood loss, hemolytic anemia, and B12 or folate deficiency. Sixty‐one percent of patients were admitted for reasons other than anemia or active bleeding. Following the educational intervention there was a 65.7% drop in the total number of transfusions (P < 0.0001). Decreased use occurred in all causes of anemia but only reached statistical significance in patients with hemolytic anemia (P = 0.006) and anemia of chronic disease (P < 0.0001). Although there was a trend toward a lower mean pretransfusion hemoglobin after the educational intervention, it did not reach statistical significance by unpaired t tests comparing groups, even after a stepwise analysis was performed to eliminate outlying values.
The decrease in the number of transfusions performed after the educational intervention suggests that mistransfusions occur frequently in many types of anemia, and education may be an effective way to promote the appropriate use of red blood cells. Further studies are needed to validate our observations and corroborate their significance.
D. VanderEnde ‐ none; K. Topchan ‐ none
To cite this abstract:VanderEnde D, Topchan K. The Transfusion Practices of Hospitalists at a Single Tertiary‐Care Center and Their Response to an Educational Intervention. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 134. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/the-transfusion-practices-of-hospitalists-at-a-single-tertiarycare-center-and-their-response-to-an-educational-intervention/. Accessed March 28, 2020.