Appropriateness of platelet, fresh frozen plasma and cryoprecipitate transfusion in New South Wales public hospitals.
OBJECTIVE
To estimate the appropriateness of transfusions of platelets, fresh frozen plasma (FFP) and cryoprecipitate using National Health and Medical Research Council and Australasian Society for Blood Transfusion guidelines (NHMRC/ASBT 2002).


METHODS
Three separate retrospective surveys of medical records from 1 January to 31 August 2000 (1147 transfused patients) from 14 hospitals selected randomly from all public hospitals that use these blood products in New South Wales: five tertiary referral, five major metropolitan, and four major rural (base) hospitals.


METHODS
Proportion of potentially inappropriate transfusions.


RESULTS
33% (136/414) of platelet, 37% (248/669) of FFP and 62% (37/60) of cryoprecipitate transfusions were assessed as inappropriate. By hospital type, 29% (75/259) of platelet transfusions were inappropriate at tertiary referral hospitals, 51% (40/78) at major urban hospitals, and 27% (21/79) at major rural hospitals. For FFP, 36% (112/313), 37% (80/216) and 39% (55/140) were inappropriate for referral, urban and rural hospitals, respectively. Cryoprecipitate was used almost exclusively at tertiary referral hospitals.


CONCLUSIONS
In terms of the NHMRC/ASBT guidelines on use of blood products, there is considerable inappropriate transfusion of platelets, FFP and cryoprecipitate in NSW public hospitals.
Schofield
William N
WN
Department of Public Health and Community Medicine, University of Sydney at Westmead Hospital, Main Admin. Block, Westmead Hospital, Hawkesbury Road, Westmead, NSW 2145. bills@dphcm.wsahs.nsw.gov.au
Rubin
George L
GL
Dean
Mark G
MG
D016913:Blood Component Transfusion / Q000706:statistics & numerical data*; D005169:Factor VIII; D005340:Fibrinogen; D005568:Forms and Records Control; D006753:Hospital Records / Q000592:standards* / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D008485:Medical Audit; D009517:New South Wales; D018579:Patient Selection; D010949:Plasma; D017713:Platelet Transfusion / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies
C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005340:Fibrinogen