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Trends and outcomes in multicomponent blood transfusion: an 11‐year cohort study of a large multisite academic center
Author(s) -
Perelman Iris,
Saidenberg Elianna,
Tinmouth Alan,
Fergusson Dean
Publication year - 2019
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.15260
Subject(s) - medicine , odds ratio , blood product , cryoprecipitate , confidence interval , blood transfusion , retrospective cohort study , odds , transfusion medicine , emergency medicine , cohort study , intensive care medicine , fibrinogen , surgery , logistic regression
BACKGROUND Most studies reporting on blood component utilization overlook patients transfused with more than one type of blood product (multicomponent transfusion). These patients are of importance, as they are large consumers of blood products and likely have different characteristics and outcomes than nontransfused patients and patients transfused with only one blood component type. Our study aimed to determine the prevalence of multicomponent transfusion at a large multisite academic center, as well as the patient characteristics and outcomes associated with multicomponent transfusion. METHODS A retrospective cohort study of transfused adult inpatients at the Ottawa Hospital between 2007 and 2017 was performed. Eligible transfusions were red blood cells (RBCs), platelets, plasma, cryoprecipitate, and/or fibrinogen concentrate. Descriptive analyses were done to determine multicomponent transfusion prevalence. Patient characteristics and outcomes associated with multicomponent transfusion were assessed using multivariable regressions. RESULTS Of 55,719 adult transfused inpatient admissions, 25% received a multicomponent transfusion. Multicomponent transfusion prevalence was highest in hematology (51%), cardiac surgery (45%), and critical care (40%) patients. Multivariable regression analysis showed that compared to RBC‐only transfusion, multicomponent transfusion was associated with increased odds of in‐hospital mortality (odds ratio, 3.48; 95% confidence interval [CI], 3.26–3.73), greater odds of institutional discharge as opposed to discharge home (odds ratio, 1.22; 95% CI, 1.15–1.30), and a 1.58 time increase in duration of hospitalization (95% CI, 1.54–1.62). CONCLUSION Multicomponent transfusion recipients make up a large proportion of transfused patients and have poorer outcomes. It is necessary to continue studying these patients, including outcomes and transfusion appropriateness, to inform best practices.