title: Where do all the red blood cells (RBCs) go? Results of a survey of RBC use in England and North Wales in 2014.
abstract: BACKGROUND
  Knowledge of blood utilization can assist clinicians in directing patient blood management (PBM) initiatives and can facilitate demand planning by blood services. We describe a national study of red blood cell (RBC) utilization in England and North Wales in 2014.
  
  
  METHODS
  All hospitals that are supplied with blood components by NHS Blood and Transplant (NHSBT) were asked to provide data on the age and sex of all recipients of transfusions of RBCs, and the clinical indication for every unit transfused, for two separate weeks in 2014. Clinical indication categories were derived from those used in previous studies in an English region. Completeness of data collection was checked against NHSBT issue and wastage data.
  
  
  RESULTS
  Data on 46,111 RBC units were collected, representing 73% of all RBCs issued by NHSBT during the weeks surveyed. A total of 67% of RBC units were transfused for a medical indication, with 27 and 6% being transfused for surgical and obstetric/gynecologic indications, respectively. For comparison, figures from a study in the North of England in 2009, on which this national study was based, showed that 64% of RBCs were transfused to medical patients. All but 20 units could be ascribed to a broad clinical heading, for example, "gastrointestinal bleeding."
  
  
  CONCLUSIONS
  Our findings confirm the previous regional finding that the percentage of RBC units that are transfused to surgical patients in England and North Wales is now much lower than for medical patients and suggest that PBM initiatives should now focus on medical patients.
authors.affiliation: Patients' Clinical Team, NHS Blood and Transplant, Newcastle upon Tyne.
authors.forename: Hazel
authors.initials: H
authors.lastname: Tinegate
authors.affiliation: Patients' Clinical Team, NHS Blood and Transplant, Newcastle upon Tyne.
authors.forename: Kate
authors.initials: K
authors.lastname: Pendry
authors.affiliation: Patients' Clinical Team, NHS Blood and Transplant, Newcastle upon Tyne.
authors.forename: Michael
authors.initials: M
authors.lastname: Murphy
authors.affiliation: National Comparative Audit of Blood Transfusion, NHS Blood and Transplant, Newcastle upon Tyne.
authors.forename: Paul
authors.initials: P
authors.lastname: Babra
authors.affiliation: National Comparative Audit of Blood Transfusion, NHS Blood and Transplant, Newcastle upon Tyne.
authors.forename: John
authors.initials: J
authors.lastname: Grant-Casey
authors.affiliation: Statistics and Clinical Studies, NHS Blood and Transplant, Newcastle upon Tyne.
authors.forename: Cathy
authors.initials: C
authors.lastname: Hopkinson
authors.affiliation: Transfusion Department, University Hospital of Leicester, Leicester, UK.
authors.forename: Jot
authors.initials: J
authors.lastname: Hyare
authors.affiliation: Patients' Clinical Team, NHS Blood and Transplant, Newcastle upon Tyne.
authors.forename: Megan
authors.initials: M
authors.lastname: Rowley
authors.affiliation: Statistics and Clinical Studies, NHS Blood and Transplant, Newcastle upon Tyne.
authors.forename: Frances
authors.initials: F
authors.lastname: Seeney
authors.affiliation: Transfusion Department, University Hospital of Leicester, Leicester, UK.
authors.forename: Denise
authors.initials: D
authors.lastname: Watson
authors.affiliation: Department of Haematology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wallis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004739:England; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013222:State Medicine; D014852:Wales; D055815:Young Adult