title: Blood transfusion utilization and recipient survival at Hospital das Clinicas in São Paulo, Brazil.
abstract: BACKGROUND
  The characteristics of blood recipients including diagnoses associated with transfusion and posttransfusion survival are unreported in Brazil. The goals of this analysis were: 1) to describe blood utilization according to clinical diagnoses and patient characteristics and 2) to determine the factors associated with survival of blood recipients.
  
  
  METHODS
  A retrospective cross-sectional analysis was conducted on all inpatients in 2004. Data came from three sources: The first two files consist of data about patient characteristics, clinical diagnosis, and transfusion. Analyses comparing transfused and nontransfused patients were conducted. The third file was used to determine survival recipients up to 3 years after transfusion. Logistic regression was conducted among transfused patients to examine characteristics associated with survival.
  
  
  RESULTS
  In 2004, a total of 30,779 patients were admitted, with 3835 (12.4%) transfused. These patients had 10,479 transfusions episodes, consisting of 39,561 transfused components: 16,748 (42%) red blood cells, 15,828 (40%) platelets (PLTs), and 6190 (16%) plasma. The median number of components transfused was three (range, 1-656) per patient admission. Mortality during hospitalization was different for patients whose admissions included transfusion or not (24% vs. 4%). After 1 year, 56% of transfusion recipients were alive. The multivariable model of factors associated with mortality after transfusion showed that the most significant factors in descending order were hospital ward, increasing age, increasing number of components transfused, and type of components received.
  
  
  CONCLUSIONS
  Ward and transfusion are markers of underlying medical conditions and are associated with the probability of survival. PLT transfusions are common and likely reflect the types of patients treated. This comprehensive blood utilization study, the first of its kind in Brazil, can help in developing transfusion policy analyses in South America.
authors.affiliation: Blood Systems Research Institute, 270 Masonic Avenue, San Francisco, CA 94118, USA. tgoncalez@bloodsystems.org
authors.forename: Thelma T
authors.initials: TT
authors.lastname: Goncalez
authors.forename: Ester C
authors.initials: EC
authors.lastname: Sabino
authors.forename: Ligia
authors.initials: L
authors.lastname: Capuani
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.forename: David J
authors.initials: DJ
authors.lastname: Wright
authors.forename: Judy H
authors.initials: JH
authors.lastname: Walsh
authors.forename: Joao E
authors.initials: JE
authors.lastname: Ferreira
authors.forename: Dalton A
authors.initials: DA
authors.lastname: Chamone
authors.forename: Michael P
authors.initials: MP
authors.lastname: Busch
authors.forename: Brian
authors.initials: B
authors.lastname: Custer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000401:mortality* / Q000706:statistics & numerical data*; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate