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Blood utilization in five Chinese hospitals shows low hemoglobin thresholds in medical patients.
- Source :
-
Transfusion [Transfusion] 2019 Sep; Vol. 59 (9), pp. 2820-2826. Date of Electronic Publication: 2019 May 31. - Publication Year :
- 2019
-
Abstract
- Background: The number of red blood cell units transfused per capita in China is lower than in western countries and the reason(s) for the difference is unknown.<br />Study Design and Methods: We randomly chose 5050 transfused patients from five Chinese hospitals. We compared transfused cases to nontransfused controls matched for the same underlying diagnosis. We assessed the pretransfusion hemoglobin (Hb) trigger and other clinical characteristics associated with transfusion. After stratifying by underlying disease, we compared pretransfusion Hb level in Chinese hospitals to 12 US hospitals.<br />Results: In 5050 patients who received transfusion, the pretransfusion Hb levels were lower in medical (6.3 g/dL) compared to surgical patients receiving transfusion postoperatively (8.1 g/dL). In patients with nonsurgical diagnoses, the pretransfusion Hb was much lower than that in the United States; the difference in mean Hb level varied by underlying diagnosis from 0.4 to 1.8 g/dL. In case-control analysis of cases (n = 1356) compared to controls (n = 1201), the pretransfusion Hb showed the strongest association with transfusion. Compared to 10 g/dL, the odds ratio (95% confidence interval) for pretransfusion Hb of 7 to 7.9 g/dL was 37.7 (24.8-57.4).<br />Conclusion: Transfusion triggers in five Chinese hospitals appear comparable to those in the United States for surgical patients; however, medical patients have lower pretransfusion Hb levels (approx. 6 g/dL). Of the factors assessed, the pretransfusion Hb was most strongly associated with transfusion. The clinical impact of lower transfusion thresholds used in China is unknown.<br /> (© 2019 AABB.)
- Subjects :
- Adult
Aged
Blood Transfusion methods
Case-Control Studies
China epidemiology
Erythrocyte Transfusion methods
Female
Hematologic Diseases blood
Hospitals statistics & numerical data
Humans
Male
Middle Aged
Postoperative Hemorrhage blood
Risk Factors
United States epidemiology
Blood Transfusion statistics & numerical data
Erythrocyte Transfusion statistics & numerical data
Hematologic Diseases epidemiology
Hematologic Diseases therapy
Hemoglobins analysis
Postoperative Hemorrhage epidemiology
Postoperative Hemorrhage therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1537-2995
- Volume :
- 59
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Transfusion
- Publication Type :
- Academic Journal
- Accession number :
- 31150566
- Full Text :
- https://doi.org/10.1111/trf.15385