Blood Product Stewardship in an Academic Emergency Department: A Study on Rational Utilization

Neda Ashayeri; Seyedamir Tabibzadeh Dezfooli; Mahdi Rezai; Kourosh Javdani Esfehani; Reza Mosaddegh; Arman Jahangiri; Alireza Javan

doi:10.5455/JPHCM.20240919061123

Abstract
Abstract
Background: Global blood shortages necessitate judicious blood product utilization. This study assesses blood product use in an academic emergency department (ED) to identify areas for improvement in resource stewardship.
Methods: This observational study reviewed ED records of patients receiving blood products during the first six months of 2022. Data analysis used SPSS 22, employing chi-square tests for qualitative variable relationships and t-tests/one-way ANOVA for comparing quantitative variable means across qualitative groups. Statistical significance was set at p < 0.05.
Results: Of 157 records reviewed, 55 patients (35%) received blood transfusions. Appropriate Packed Red Blood Cell (PRBC) reservation and transfusion rates were 74% and 91.1%, respectively. 43 units of PRBC (42.2%, 95% CI 32.4-52.9%) and 12 units of Fresh Frozen Plasma (FFP) (23.5%, 95% CI 13.7-35.3%) were used; reserved platelets were unused. Analysis revealed significantly higher PRBC consumption than expected (p = 0.025, Chi-square). While the average age of transfused patients (59.14, 95% CI 53.14-64.4) was higher than those not transfused (55.7, 95% CI 51.53-59.4), this difference was not statistically significant (p = 0.316).
Conclusion: This study highlights the need for more cautious blood product reservation, even within an academic ED setting, to optimize resource allocation and reduce waste.

Key words: Blood Transfusion, Packed Red Blood Cell (PRBC), Fresh Frozen Plasma (FFP), Blood Product Stewardship, Emergency Department