A retrospective review of cryoprecipitate transfusion practice in Kuala Lumpur Hospital.
BACKGROUND
Cryoprecipitate is generally used to treat bleeding patients with hypofibrinogenemia, and the transfusion decision is guided based on published guidelines.


OBJECTIVE
This study aimed to evaluate the practice appropriateness in accordance to cryoprecipitate transfusion guidelines in Hospital Kuala Lumpur.


METHODS
This cross-sectional study of 117 cryoprecipitates transfused adult patients was conducted in Kuala Lumpur Hospital from January to June 2012. The compliance of the indication of cryoprecipitate was considered as appropriate if indicated for patients who have hypofibrinogenemia (<1.0 g/L) with bleeding, or otherwise inappropriate if pretransfusion fibrinogen level was more than 1.0 g/L, pretransfusion fibrinogen level was not examined and posttransfusion fibrinogen level more than 1.5 g/L.


RESULTS
Most of the cryoprecipitate prescriptions were found to be inappropriate, which read 81.2% (95% confidence interval = 0.740, 0.880). Patients who underwent neurovascular surgery were the major recipient of cryoprecipitate, but majority of the prescription was found not appropriate. The decision to transfuse cryoprecipitate was found mostly appropriate when was guided by fibrinogen (52.2%), but the percentage dropped to 10.6% when pretransfusion fibrinogen test was not performed. Regrettably, only 19.7% of total cryoprecipitate were given based on pretransfusion fibrinogen level.
Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains, 13200 Bertam, Kepala Batas, Penang, Malaysia; National Blood Centre, Malaysian Ministry of Health, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia.
Intan Iliana
II
Iliassa
Department of Community Medicine, Universiti Sains, 16150 Kota Bahru, Kelantan, Malaysia.
Wan Mohd Zahiruddin Wan
WM
Mohammad
Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains, 13200 Bertam, Kepala Batas, Penang, Malaysia.
Jun Jie
JJ
Tan
National Blood Centre, Malaysian Ministry of Health, Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia.
Yasmin
Y
Ayob
Appropriateness; bleeding; cryoprecipitate transfusion; guideline