Oct
2014

Restrictive blood transfusion practices are associated with improved patient outcomes.

Goodnough LT, Maggio P, Hadhazy E, et al.
Transfusion 2014;54:2753-2759.
NATA Rating :
Review by : P. Van der Linden / D. Thomas
NATA Review

This retrospective analysis evaluated the clinical impact of the implementation of a clinical decision support system using a best practice alert at computerised physician blood transfusion order entry.

The authors report two important results:
1. Implementation of such a rigorous approach a the hospital level was associated with a significant reduction in red blood cell utilisation, which in turn resulted in hospital-wide improvement in clinical patient outcomes as well as in significant cost savings.
2. In transfused patients, outcome improvements appeared even more pronounced.

Despite the limitations associated with the study design, these results confirm that improved blood utilisation at the hospital level improves global quality of care while decreasing blood transfusion-related costs.

– Philippe Van der Linden

This paper is essential reading for all clinicians who are involved in transfusion. Using a retrospective audit of blood transfusion activities at a large institution, the authors have report the positive effect of a restrictive transfusion regimen. The results are impressive. The report shows that there has been a very consistent alteration in transfusion practices resulting in the use of less allogeneic components, very positive patient outcomes associated with an equally beneficial reduction in overall cost. The effort involved in achieving this change of practice should not be underestimated. However, it will encourage many clinicians to strive to achieve this practice within their own environment.

– Dafydd Thomas

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