P18 Which Patients Receive Platelets Transfusions in the South West Region and Why?

  Although the use of red cells in England has declined since 2000 platelet transfusions have continued to increase and this rise has been more pronounced in the South West (issue figures between April 02 and March 05 identify a 22.5% increase compared with 7.5% nationally). To investigate this the South West Regional Blood Transfusion Committee organised a study to determine which patients are being transfused platelets and why. Methods  Information was collected for one month, 14th November to 11th December 2005, by transfusion laboratory staff and a simple data set was defined to identify ‐ age of the recipient, directorate/specialty, use for prophylaxis/bleeding, operation (if relevant), platelet count prior to issue and number of doses requested and number used. Results  A total of 21 out of 28 hospitals returned satisfactory information. Overall 1323 units were requested and 1226 (93%) units used for the initial request. Using NBS issue data this represents 86% (1323/1535) of all platelets issued to participating hospitals. Variation in usage between hospitals was large with 4 hospitals requesting more than 100 and 2 hospitals requesting more than 200 units. Platelet use increased with age and over 500 units were requested for patients 65 years or over. 779 units (59% total), were requested for haematology patients. Oncology and cardiac surgery were the next highest users requesting 149 (11% total) and 139 (11% total) respectively. When prophylactic or therapeutic use was known, 904 units (74%) were requested for prophylaxis. 75% of these were for haematology patients and 73% when the preceding platelet count was greater than 10 × 10 9  L −1 . 310 (24%) units were requested for bleeding. 30% of these were for cardiac surgery and 53% when the previous count was more than 50 × 10 9  L −1 . Conclusion  This study indicates that around 40% of all platelet requests are to prevent bleeding in haematology patients when the preceding platelet count is greater than 10 × 10 9  L −1 . The increasing age profile of the population is likely to put greater demands on the National Blood Service to collect platelets with increasing cost to the hospitals unless platelet use alters. The current British Society of Haematology guidelines should be followed whenever possible and further work to assess the need for prophylactic platelet transfusions should be performed. Acknowledgements  The Executive working group of the RTC would like to thank all the regional Blood Transfusion Laboratory managers for their assistance with this audit.