Epidemiología de la transfusión sanguínea en los Servicios de Medicina Intensiva en España: «Transfusion Day» / Epidemiology of blood transfusion in the Spanish Critical Care Units: «Transfusion Day»

Objective: To describe the transfusion practice in the ICUs in Spain, according to national and international recommendations (guidelines). Design: Prospective, cross-sectional, multi-centre study. Scope: Data collection was carried out by means of a questionnaire sent electronically to the Heads of Service of 111 ICUs in Spain. Participants: 1,448 patients were included, aged 61.8 (SD 15.7) years, 66.2% male, with an SOFA of 4.7 ± 3.8 and average stay of 10.62 ± 17.49 days. Variables: Demographic and clinical variables of the patients were collected, as well as variables related to the transfusion act. Results: Of the 1,448 patients, 9.9% received al least one transfusion of any blood product, 3.7% fresh plasma, 3.9% platelets and 8.9% red blood cell concentrate, mainly by analytical criteria (36.2%). Hemoglobin had a mean of 7.8 g/dL (95% CI: 6-9-8.5) and 9.8 g/dL (95% CI: 8.5–11.2) before and after the transfusion, respectively, p < 0.001. The transfusion units had a mean of 2.5 ± 2.4 per patient. The most commonly used blood product was red blood cell concentrate (CH) (90.2%). Patients admitted for surgery had a higher transfusion rate (14.4%) than those admitted for medical pathology (8.9%) (p = 0.006). 5.4% (7/129) of patients who received CH died compared to 2.4% (31/1302) who did not (p = 0.04). Mortality of transfused patients was higher. The transfusion rate in most of hospitals was 5% to 20%, with 18 hospitals (16.21%) having transfusion rates between 20% and 50%. Hospitals with PBM programs and mass transfusion programs had a lower transfusion rate, although not statistically significant. Conclusions: In this multicenter cross-sectional study, a transfusion prevalence of 9.9% was observed in Spanish Critical Care Units. The most frequent blood product transfused was red blood cells and the main reasons for transfusion were acute anemia with hemodynamic impact and analytical criteria. Mortality of transfused patients was higher (AU)

Objetivo: Describir la práctica transfusional en las UCIs de España, acorde con recomendaciones (guidelines) nacionales e internacionales. Diseño: Estudio prospectivo, transversal y multicéntrico. Ámbito: La recogida de datos se realizó mediante una encuesta enviada electrónicamente a los médicos intensivistas de 111 UCIs de España. Participantes: Se incluyeron 1.448 pacientes, de 61,8 (DE 15,7) años, el 66,2% varones, con un SOFA de 4,7 ± 3,8 y estancia media de 10,62 ± 17,49 días. Variables: Se recogieron variables demográficas y clínicas de los pacientes, así como variables relacionadas con el propio acto transfusional. Resultados: De los 1.448 pacientes, el 9,9% recibieron al menos una transfusión de cualquier hemocomponente, 3,7% de plasma fresco, 3,9% de plaquetas y 8,9% de concentrado de hematíes, siendo la causa principal el umbral transfusional basado en la hemoglobina (36,2%). La hemoglobina tuvo una media de 7,8 g/dL (IC 95%: 6,9–8,5), y de 9.8 g/dl (IC95%: 8,5–11,2) antes y después de la transfusión respectivamente (p < 0,001). Las unidades transfundas tuvo una media por paciente de 2,5 ± 2,4 por paciente. El hemoderivado más utilizado fue el concentrado de hematíes (CH) (90,2%). Los pacientes ingresados por motivos quirúrgicos tuvieron una tasa de transfusión mayor (14,4%) respecto a los ingresados por patología médica (8,9%) (p = 0,006). El 5,4% (7/129) de los pacientes que recibieron CH fallecieron respecto el 2,4% (31/1302) que no lo recibieron (p = 0,04). La tasa de transfusión en la mayor parte de hospitales fue de 5% al 20%, habiendo 18 hospitales (16.21%) con tasas de transfusión entre el 20% y el 50%. Los hospitales con programas PBM y programas de transfusión masiva tuvieron una menor tasa de transfusión, aunque sin ser significativa. Conclusiones: En este estudio multicéntrico de corte transversal se observó una prevalencia transfusional en las unidades de críticos españolas del 9,9% (AU)

Epidemiology of blood transfusion in the Spanish Critical Care Units: «Transfusion Day¼.

OBJECTIVE: To describe the transfusion practice in the ICUs in Spain, according to national and international recommendations (guidelines). DESIGN: Prospective, cross-sectional, multi-centre study. SCOPE: Data collection was carried out by means of a questionnaire sent electronically to the Heads of Service of 111 ICUs in Spain. PARTICIPANTS: 1,448 patients were included, aged 61.8 (SD 15.7) years, 66.2% male, with an SOFA of 4.7 ±â€¯3.8 and average stay of 10.62 ±â€¯17.49 days. VARIABLES: Demographic and clinical variables of the patients were collected, as well as variables related to the transfusion act. RESULTS: Of the 1,448 patients, 9.9% received al least one transfusion of any blood product, 3.7% fresh plasma, 3.9% platelets and 8.9% red blood cell concentrate, mainly by analytical criteria (36.2%). Hemoglobin had a mean of 7.8 g/dL (95% CI: 6-9-8.5) and 9.8 g/dL (95% CI: 8.5-11.2) before and after the transfusion, respectively, p < 0.001. The transfusion units had a mean of 2.5 ±â€¯2.4 per patient. The most commonly used blood product was red blood cell concentrate (CH) (90.2%). Patients admitted for surgery had a higher transfusion rate (14.4%) than those admitted for medical pathology (8.9%) (p = 0.006). 5.4% (7/129) of patients who received CH died compared to 2.4% (31/1302) who did not (p = 0.04). Mortality of transfused patients was higher. The transfusion rate in most of hospitals was 5% to 20%, with 18 hospitals (16.21%) having transfusion rates between 20% and 50%. Hospitals with PBM programs and mass transfusion programs had a lower transfusion rate, although not statistically significant. CONCLUSIONS: In this multicenter cross-sectional study, a transfusion prevalence of 9.9% was observed in Spanish Critical Care Units. The most frequent blood product transfused was red blood cells and the main reasons for transfusion were acute anemia with hemodynamic impact and analytical criteria. Mortality of transfused patients was higher.

Epidemiology of blood transfusion in the Spanish Critical Care Units: «Transfusion Day¼. / Epidemiología de la transfusión sanguínea en los Servicios de Medicina Intensiva en España: «Transfusion Day¼.

OBJECTIVE: To describe the transfusion practice in the ICUs in Spain, according to national and international recommendations (guidelines). DESIGN: Prospective, cross-sectional, multi-centre study. SCOPE: Data collection was carried out by means of a questionnaire sent electronically to the Heads of Service of 111 ICUs in Spain. PARTICIPANTS: 1,448 patients were included, aged 61.8 (SD 15.7) years, 66.2% male, with an SOFA of 4.7±3.8 and average stay of 10.62±17.49 days. VARIABLES: Demographic and clinical variables of the patients were collected, as well as variables related to the transfusion act. RESULTS: Of the 1,448 patients, 9.9% received al least one transfusion of any blood product, 3.7% fresh plasma, 3.9% platelets and 8.9% red blood cell concentrate, mainly by analytical criteria (36.2%). Hemoglobin had a mean of 7.8g/dL (95% CI: 6-9-8.5) and 9.8g/dL (95% CI: 8.5-11.2) before and after the transfusion, respectively, p<0.001. The transfusion units had a mean of 2.5±2.4 per patient. The most commonly used blood product was red blood cell concentrate (90.2%). Patients admitted for surgery had a higher transfusion rate (14.4%) than those admitted for medical pathology (8.9%) (p=0.006). 5.4% (7/129) of patients who received red blood cell concentrate died compared to 2.4% (31/1302) who did not (p=0.04). Mortality of transfused patients was higher. The transfusion rate in most of hospitals was 5% to 20%, with 18 hospitals (16.21%) having transfusion rates between 20% and 50%. Hospitals with PBM programs and mass transfusion programs had a lower transfusion rate, although not statistically significant. CONCLUSIONS: In this multicenter cross-sectional study, a transfusion prevalence of 9.9% was observed in Spanish critical care units. The most frequent blood product transfused was red blood cells and the main reasons for transfusion were acute anemia with hemodynamic impact and analytical criteria. Mortality of transfused patients was higher.