The use of blood transfusions and erythropoietin-stimulating agents in Swedish palliative care.
OBJECTIVE
To outline the use of blood transfusions and erythropoietin-stimulating agents (ESAs) in palliative care in Sweden and to get an idea of whether or not these usually very sick patients benefit from the treatment.


METHODS
An internet-based questionnaire was sent out to 24 specialized palliative care units within the Swedish palliative research network. All data were registered by each member directly into a web-based survey generator from which the results were extracted and analyzed.


RESULTS
Twenty-two units registered 1,046 patients (median age 68 years, 87% had a cancer diagnosis). Among these patients, 900 were enrolled in advanced home care and the others were treated in in-patient units. Erythrocyte transfusions were given to 174 patients (17%) during the month before registration with a mean amount of 2.9 units (range 1-18) given to each patient. Erythrocyte transfusions were given to 18% of the patients with a malignancy and to 11% of the patients with a non-malignant disease. Six patients also received thrombocyte transfusions. One hundred seventeen patients (68%) were judged to benefit from the erythrocyte transfusions. Eighty-two (58%) of the 141 transfused patients enrolled in advanced home care received their transfusions in their homes. ESAs was given to 127 patients (12%).


CONCLUSIONS
Transfusions are not uncommon in Swedish palliative care. A majority seemed to benefit from the transfusions. Since they are expensive and time consuming, the effect should, however, be carefully evaluated in every individual in order to avoid ineffective treatment.
Martinsson
Ulla
U
Department of Oncology, University Hospital, 751 85, Uppsala, Sweden. ulla.martinsson@akademiska.se
Lundström
Staffan
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004921:Erythropoietin / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D013548:Sweden; D055815:Young Adult
D004921:Erythropoietin
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