Development of a Transfusion-Indication Data-Entry Program and Analysis of Transfusion Indications at a University Hospital in Korea

Abstract

Background: Transfusion guidelines are not only essential for the optimal use of blood products, but also help reduce transfusion-related adverse reactions and improve patients’ outcomes. In this hospital, a transfusion-indication data-entry program based on the national transfusion guidelines was developed and applied to the electronic medical record system in 2016. All transfusion orders, except for emergencies, have been performed using this program since then. This study analyzed the reasons for the transfusion to monitor the blood product usage and provide feedback to clinicians. Methods: The transfusion-indications were classified by the blood product and a pop-up window listing these indications was produced. The indications were as follows: red blood cells (RBCs) - acute blood loss, chronic anemia, surgery/procedure, transplantation and ‘other’; platelets (PLTs) - active bleeding, bleeding prophylaxis, surgery/procedure, massive transfusion, and ‘other’; fresh frozen plasma (FFP) - bleeding in coagulopathy, bleeding prophylaxis in coagulopathy, massive transfusion, plasma exchange, and ‘other’. The indications entered into the data-entry program from Sep 2016 to Feb 2018 were analyzed. Results: The most common indications for transfusion were chronic anemia for RBCs (7977/16138, 49.4%), bleeding prophylaxis for PLTs (5726/11158, 51.3%), and ‘other’ for FFP (2180/6024, 36.2%). Many clinicians entered the transfusion indication as ‘other’, but the free-text supplied by the clinician when ‘other’ was selected, often corresponded to an indication already categorized in the transfusion-indication data-entry program. Conclusion: Feedback and training on the data of transfusion indications are needed for clinicians to properly use blood products by operating the transfusion-indication data-entry program more efficiently. (Korean J Blood Transfus 2019;30:138-147)