engleski

Is transfusion of one unit red blood cells good clinical practice?

Background. There is no strict clinical indication for one unit transfusion (OUT). The aim of the study was to determine whether OUT is criterion of poor patient care. Methods. Medical records of 148 patients (pts) who have received OUT at the Department of Medicine in the period from 1997 to 2000 were retrospectively studied. Results. The study included 148 pts, 72 (48, 6%) females and 76 (51, 4%) males, mean age 66, 8+/-14, 5 years. Their underlaying diseases were: acute gastrointestinale bleeding 41 (27, 7%)pts, acute coronary syndrome 39 (26, 4%) pts, malignancy 30(20, 3%)pts, hemathological disorders 19 (12, 6%) pts, and others 19 (13, 1%). 73 (49, 3%) pts had chest pain, and 72 (51, 4%) of them had ECG changes before OUT. Pretransfusion mean hemoglobin (Hb1) value was 85+/-12 (mod 78) g/L, increasing to 96, 9+/-11, 8 (mod 90) g/L (Hb2) after OUT. In 3 cases Hb2 values decreased after transfusion. In 17 (11, 5%) cases Hb2 values increased less than 5 g/L (group A), in 38 (25, 7%) pts hemoglobin increased between 5-10 g/L (group B) and in 90 (60, 8%) pts more than 10 g/L (group C). In the group A and B (55 pts) 19 pts (34, 5%) died during the hospital stay versus group C (90 pts) in which 7 (7, 8%) pts died. Conclusion. The mortality rate was significantly lower in pts whose Hb2 values increased more than 10 g/L after OUT (p=0, 001). The majority od OUT were appropriate for clinical situation.

blood transfusion; one unit transfusion; hemoglobin level; outcome

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