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9. Assessing the Accuracy of Reporting of Maternal Red Blood Cell Transfusion at Birth Reported in Routinely Collected Hospital Data

Author

Patterson, Jillian A., Francis, Sally, and Ford, Jane B.

Subjects
Usage, Analysis, Research, Delivery (Childbirth) -- Analysis, Red blood cells -- Research, Blood transfusion -- Usage, Data collection -- Usage
Abstract

Author(s): Jillian A. Patterson[sup.1] , Sally Francis[sup.2] , Jane B. Ford[sup.1] Author Affiliations: (1) Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, c/- University Dept of O&G, [...], Introduction Hospital administrative data collections have been used to describe transfusion practice, particularly in relation to the maternity population. Knowledge of the accuracy of this data is important in order to interpret the results of such studies. The aim of this study was to compare the accuracy of reporting of red cell transfusion around childbirth within hospital data with data submitted by hospital blood banks. Methods Linked hospital and birth data from New South Wales, Australia, between June 2006 and December 2010 were used to identify blood transfusions occurring at delivery. This reporting was compared with the gold standard of blood pack level information submitted by hospital blood banks, and sensitivity, specificity, and positive and negative predictive values calculated. Reporting related to quantity and timing of transfusion were also considered. Results Data were available for 235,796 births, with blood bank data identifying that 2.0 % of received a blood transfusion. Overall the sensitivity of hospital data for identifying transfusion was 84.8 % (95 % CI 83.7 %, 85.8 %) with specificity 99.9 % (99.9 %, 99.9 %). Sensitivity was better for births involving a postpartum haemorrhage [Sn 90.9 % (89.9 %, 91.9 %)], and poorer for births in regional hospitals [Sn 78.8 % (76.0 %, 81.5 %)]. Almost all (96 %) transfusions of 10 or more units were identified in hospital data, and there was no difference in reporting depending on whether the transfusion was on the baby's date of birth or not. Discussion The reliability of hospital reporting of transfusion in maternity patients is high, however with some underreporting of cases.

Published
2016
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36. Trends in postpartum haemorrhage

Author

Cameron, Carolyn A., Roberts, Christine L., Olive, Emily C., Ford, Jane B., and Fischer, Wendy E.

Subjects
Australians -- Forecasts and trends, Australians -- Health aspects, Hemorrhage -- Forecasts and trends, Hemorrhage -- Patient outcomes, Hospitals -- Admission and discharge, Hospitals -- Forecasts and trends, Market trend/market analysis, Health
Abstract

Objective: To assess trends and outcomes of postpartum haemorrhage (PPH) in New South Wales (NSW). Methods: A population-based descriptive study of all 52,151 women who had a PPH either during the hospital stay for the birth of their baby or requiring a re-admission to hospital between 1994 and 2002. Data were obtained from the de-identified computerised census of NSW hospital in-patients and analysed to examine trends over time. The outcome measures included maternal death, hysterectomy, admission to intensive care unit (ICU), transfusion and major maternal morbidity, including procedures to reduce blood supply to the uterus, acute renal failure and postpartum coagulation defects. Results: From 1994 to 2002 both the number and adjusted (for under-reporting) rate of PPH during the birth admission increased from 8.3% of deliveries to 10.7%. The rate of PPH adjusted for maternal age and mode of delivery was similar to the unadjusted rate. There was a sixfold increase in the rate of transfusions from 1.9% of women who haemorrhaged to 11.7%. Hospital readmissions for PPH declined from 1.2% of deliveries to 0.9%. These were statistically significant changes. There were no significant changes in the rate of hysterectomies, procedures to reduce blood supply to the uterus, admissions to ICU, acute renal failure or coagulation defects. Conclusion: The increased rate of PPH during the birth admission is concerning. The increase in PPH could not be explained by increasing maternal age or caesarean sections. Linked birth and hospital discharge data could determine whether the increase in PPH is caused by other changes in obstetric practices or population.

Published
2006

48. Rates of neonatal morbidity by maternal region of birth and gestational age in New South Wales, Australia 2003‐2016

Author

Berman, Ye’elah, primary, Ibiebele, Ibinabo, additional, Randall, Deborah, additional, Torvaldsen, Siranda, additional, Nippita, Tanya A., additional, Bowen, Jennifer, additional, Baldwin, Heather J., additional, Todd, Stephanie M., additional, Morris, Jonathan M., additional, Ford, Jane B., additional, and Patterson, Jillian A., additional

Published
2020
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