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Mortazavi H, Mohammadi A, Sharifian E, Firouzeh N, van Belkum A, Ghasemzadeh-Moghaddam H. The effect of aging on the epidemiology of blood transfusions in North Khorasan province, Iran. AMERICAN JOURNAL OF BLOOD RESEARCH 2023; 13:44-52. [PMID: 36937460 PMCID: PMC10017592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/05/2023] [Indexed: 03/21/2023]
Abstract
PURPOSE Additional knowledge on the epidemiology and recipients of blood transfusions will help health-care managers to estimate the future needs. The study was performed to define the blood transfusion rate based on gender, sex, and clinical features of patients receiving blood products in all hospitals of the North Khorasan province of Iran. METHODS Data on blood transfusion implementation were extracted from blood bank documents. The data for all patients who received at least one blood product were collected from March 2018 to March 2019. RESULTS Among blood transfused patients, the highest transfusion rate was for packed red blood cells (PRBC) (47.7%). The two other most frequently used products were fresh frizzed plasma (FFP) (27.2%) and platelets (PLT) (21.9%). The patients in the age group of 51-80 years received the majority of PRBCs and FFPs. Patients aged 21-40 and 61-70 yrs had the highest transfusion rates for PLT. Elderly female patients (57.4%) received more blood products than their male counterparts. The highest blood transfusion rates were among patients with neoplasms, anemia, gastrointestinal bleeding, and gastric diseases. CONCLUSION The primary Iranian blood recipients were elderly patients. Population aging is associated with an increase in the number of blood recipients and simultaneously declines the blood donors pool. It highlights the need for optimizing the use of blood in hospitals and having better strategies for overcoming the shortage of blood.
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Affiliation(s)
- Hamed Mortazavi
- Department of Geriatric Nursing, Gerontological Care Research Center, School of Nursing and Midwifery, North Khorasan University of Medical SciencesBojnurd, Iran
| | - Akbar Mohammadi
- Department of Geriatric Nursing, Gerontological Care Research Center, School of Nursing and Midwifery, North Khorasan University of Medical SciencesBojnurd, Iran
| | - Elham Sharifian
- Department of Statistic and Epidemiology, North Khorasan University of Medical SciencesBojnurd, Iran
| | - Nima Firouzeh
- Vector-Borne Diseases Research Center, North Khorasan University of Medical SciencesBojnurd, Iran
| | - Alex van Belkum
- Open Innovation & Partnerships, BaseClearSylviusweg 74, 2333 BE Leiden, The Netherlands
| | - Hamed Ghasemzadeh-Moghaddam
- Vector-Borne Diseases Research Center, North Khorasan University of Medical SciencesBojnurd, Iran
- Department of Pathobiology and Laboratory Sciences, School of Medicine, North Khorasan University of Medical SciencesBojnurd, Iran
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Eichler H, Feyer AK, Weitmann K, Hoffmann W, Henseler O, Opitz A, Patek A, Hans DN, Schönborn L, Greinacher A. Population-Based Analysis of the Impact of Demographics on the Current and Future Blood Supply in the Saarland. Transfus Med Hemother 2020; 48:175-182. [PMID: 34177423 DOI: 10.1159/000512645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/19/2020] [Indexed: 12/14/2022] Open
Abstract
Background The federal state of Saarland (SL) is experiencing the fastest demographic change in the western part of Germany. In this study, we analyzed retrospective data on the current and future supply of red blood cell concentrates (RBC) in this region and compared it to the current and future RBC demand in SL hospitals. Methods The projection of the SL blood supply in 2030 was modeled based on SL demographics for age distribution and donation frequency of donors, and the RBC transfusion data for in-house patients. These results were compared to published data on the transfusion demand from the state of Mecklenburg-Western Pomerania (MV). Results For the period January 1 to December 31, 2017, a total of 43,205 whole blood donations were collected. The donation frequency in SL never exceeded 80 per 1,000 inhabitants and was well below the numbers in MV. Thirty-one percent of the donors were responsible for 53.5% of the donations, and donors older than 45 years of age contributed highly to the total blood supply. In addition, 40,614 RBC transfusions at 10 SL hospitals were analyzed representing nearly all RBC transfusions for in-house patients in this region. RBC transfusions per 1,000 inhabitants increased with age from 24 (50-54) to 140 (80-84) years. Facing an already existing structural deficit of nearly 8,200 RBC in 2017, the projection predicts a dramatic increase in the regional deficit to >18,300 RBC in 2030. Conclusion Our results on RBC demand in SL are comparable but not identical to those projected for the region of MV in eastern Germany. Due to the ongoing demographic changes in Germany as a whole, regular regional monitoring of RBC demand and the age structure of blood recipients and donors should be implemented to allow for better strategic planning in blood transfusion services and hospitals.
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Affiliation(s)
- Hermann Eichler
- Universität des Saarlandes, Institut für Klinische Hämostaseologie und Transfusionsmedizin, Homburg, Germany
| | - Anna Katharina Feyer
- Universität des Saarlandes, Institut für Klinische Hämostaseologie und Transfusionsmedizin, Homburg, Germany
| | - Kerstin Weitmann
- Universitätsmedizin Greifswald, Institut für Community Medicine, Greifswald, Germany
| | - Wolfgang Hoffmann
- Universitätsmedizin Greifswald, Institut für Community Medicine, Greifswald, Germany
| | | | - Andreas Opitz
- DRK-Blutspendedienst Rheinland-Pfalz und Saarland, Bad Kreuznach, Germany
| | - Alexander Patek
- Blutspendezentrale Saar-Pfalz, Klinikum Saarbrücken, Saarbrücken, Germany
| | | | - Linda Schönborn
- Universitätsmedizin Greifswald, Institut für Immunologie und Transfusionsmedizin, Greifswald, Germany
| | - Andreas Greinacher
- Universitätsmedizin Greifswald, Institut für Immunologie und Transfusionsmedizin, Greifswald, Germany
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Schönborn L, Weitmann K, Greinacher A, Hoffmann W. Characteristics of Recipients of Red Blood Cell Concentrates in a German Federal State. Transfus Med Hemother 2020; 47:370-377. [PMID: 33173455 PMCID: PMC7590768 DOI: 10.1159/000510207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/05/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Annual transfusion rates in many European countries range between 25 and 35 red blood cell concentrates (RBCs)/1,000 population. It is unclear why transfusion rates in Germany are considerably higher (approx. 50-55 RBCs/1,000 population). METHODS We assessed the characteristics of transfusion recipients at all hospitals of the German federal state Mecklenburg-Western Pomerania during a 10-year longitudinal study. RESULTS Although 75% of patients received ≤4 RBCs/patient in 2015 (1 RBC: 11.3%; 2 RBCs: 42.6%; 3 RBCs: 6.3%; 4 RBCs: 15.0%), the mean transfusion index was 4.6 RBCs due to a minority of patients with a high transfusion demand. Two thirds of all RBCs were transfused to only 25% of RBC recipients. Consistently, male patients received a higher number of RBCs (2005: 54.2%; 2015: 56.8%) and had a higher mean transfusion index than female patients (mean 5.1 ± 7.2; median 2; inter-quartile range [IQR] 2-4 vs. mean 4.0 ± 5.8; median 2; IQR 2-4). The absolute transfusion demand decreased between 2005 and 2015 by 13.5% due to a composite of active reduction (clinical practice change) and population decline in the 65- to 75-year age group (lower birth rate cohort 1940-1950); however, with major differences between hospitals (range from -61.0 to +41.4%). CONCLUSION Transfusion demand in a population could largely be driven by patients with high transfusion demand. Different treatment practices in this group of patients probably add to the major differences in transfusion demand per 1,000 individuals between countries. The available data cannot prove this hypothesis. Implementation of a diagnosis-related group-based monitoring system is urgently needed to allow informative monitoring on the population level and meaningful comparisons between transfusion practices.
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Affiliation(s)
- Linda Schönborn
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Kerstin Weitmann
- Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Andreas Greinacher
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
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Leucoreduction of blood components: an effective way to increase blood safety? BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 14:214-27. [PMID: 26710353 DOI: 10.2450/2015.0154-15] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 08/31/2015] [Indexed: 02/08/2023]
Abstract
Over the past 30 years, it has been demonstrated that removal of white blood cells from blood components is effective in preventing some adverse reactions such as febrile non-haemolytic transfusion reactions, immunisation against human leucocyte antigens and human platelet antigens, and transmission of cytomegalovirus. In this review we discuss indications for leucoreduction and classify them into three categories: evidence-based indications for which the clinical efficacy is proven, indications based on the analysis of observational clinical studies with very consistent results and indications for which the clinical efficacy is partial or unproven.
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IGISSINOV N, KULMIRZAYEVA D, MAGZUMOVA R, SIBINGA CTS, ALPEISSOVA S. Trends of Blood and Plasma Donations in Kazakhstan: 12-Years Retrospective Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2014; 43:601-9. [PMID: 26060761 PMCID: PMC4449408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 03/20/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Each country faces a continuing challenge to collect enough blood to meet the national needs. According to WHO, there should be at least 20 blood donations per 1,000 population for developing countries, in Kazakhstan this indicator was only 16.8 in 2011. Thus, we conducted an epidemiological assessment and drew a map of the regional distribution of blood and plasma donations in Kazakhstan during the years 2000-2011. METHODS The retrospective study was conducted from 2000 to 2011. Data on blood and its components donations were acquired from the Ministry of Health (annual statistical reporting form N° 39). RESULTS During 2000-2011, number of blood donors decreased to 17.4% and blood donations to 6.3%. The proportion of non-remunerated blood donations and donors decreased from 97.6% to 77.9% and 97.9% to 87.7%, respectively. The paid donations had the opposite trend. Number of plasma donors increased in 2.1 times, plasma donations in 2.4 times, nevertheless the proportion of non-remunerated plasma donations decreased from 60.1% to 29.8%. The average number of blood donations per 1,000 population decreased from 19.8 (2000) to 16.8 (2011), plasma donations increased from 1.4 to 3.1. Regionally, annual average rates of blood and plasma donations per 1,000 population over 12 years varied greatly. CONCLUSION This is the first study conducted in Kazakhstan to provide detailed information, including the regional characteristics of blood and plasma donations over an extended period of time, which can be used in blood transfusion services work.
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Affiliation(s)
- Nurbek IGISSINOV
- 1. Republican Institute of Postgraduate Medical Education, Astana, Kazakhstan,2. PA “Central Asian Cancer Institute”, Astana, Kazakhstan,* Corresponding Author:
| | - Dariyana KULMIRZAYEVA
- 2. PA “Central Asian Cancer Institute”, Astana, Kazakhstan,3. JSC “Astana Medical University”, Astana, Kazakhstan
| | | | | | - Sholpan ALPEISSOVA
- 5. National Research Center of Surgery named After Syzganov, Astana, Kazakhstan
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Lawani OL, Iyoke CA, Onyebuchi AK. Blood transfusion trends in obstetrics at the Federal Teaching Hospital in Abakaliki, South-East Nigeria. Int J Womens Health 2013; 5:407-12. [PMID: 23874125 PMCID: PMC3713898 DOI: 10.2147/ijwh.s45165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Obstetric hemorrhage has been repeatedly implicated as a leading cause of maternal mortality in Nigeria, yet there are very few studies that evaluate the practice of blood transfusion in obstetrics as a life saving measure. Objectives The aim of this study was to evaluate the practice of obstetric blood transfusion, the mean decision-transfusion interval, and the outcome in parturients who had blood transfusions. Methods This was a prospective descriptive study conducted at the Federal Teaching Hospital, Abakaliki, South-East Nigeria, between 1st January, 2012 and 31st December, 2012. Statistical analysis was done using SPSS version 15.0 for Windows. Results Out of 151 parturients who received blood transfusion, 141/151 (97.4%) were knowledgeable about blood transfusion, while only 10/151 (2.6%) had no knowledge of it. The hospital was the source of information for 120/151 (80.8%) of the participants. Blood transfusion rate was 7.04% of all parturients. The mean decision-transfusion interval was 12.0 ± 4.3 hours. All participants were transfused with either whole blood or sedimented cells. The mean number of blood units transfused was 1.77 ± 0.93 units. The indications for transfusion were: anemia, 109/151 (72.2%); shock, 13/151 (8.6%); postpartum hemorrhage, 23/151 (15.2%); antepartum hemorrhage, 6 (4%). Six (4%) women died; mortality was due to renal failure in 3/6 (50%) and disseminated intravascular coagulopathy in 3/6 (50%). These deaths were due to delays and difficulty in securing blood for transfusion, while those who got transfused on time were salvaged with minimal morbidity, 21/151 (14%), or with no morbidity, 130/151 (86%). Conclusion Excessive blood loss and anemia still complicate most pregnancies in our practice and the mean decision-transfusion interval is unacceptably long with debilitating maternal morbidity and mortality that can be improved with safe and effective blood transfusion with minimal or no risk.
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Affiliation(s)
- Osaheni L Lawani
- Department of Obstetrics and Gynecology, Federal Teaching Hospital, Ebonyi State, Nigeria
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Goncalez TT, Sabino EC, Capuani L, Liu J, Wright DJ, Walsh JH, Ferreira JE, Chamone DA, Busch MP, Custer B. Blood transfusion utilization and recipient survival at Hospital das Clinicas in São Paulo, Brazil. Transfusion 2012; 52:729-38. [PMID: 22593845 PMCID: PMC3703955 DOI: 10.1111/j.1537-2995.2011.03387.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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. STUDY DESIGN AND 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. CONCLUSION 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.
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Affiliation(s)
- Thelma T Goncalez
- Blood Systems Research Institute, 270 Masonic Avenue, San Francisco, CA 94118, USA.
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Muñoz M, Slappendel R, Thomas D. Laboratory characteristics and clinical utility of post-operative cell salvage: washed or unwashed blood transfusion? BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2011; 9:248-61. [PMID: 21084005 PMCID: PMC3136591 DOI: 10.2450/2010.0063-10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Accepted: 08/04/2010] [Indexed: 01/18/2023]
Affiliation(s)
- Manuel Muñoz
- International Group of Interdisciplinary Studies about Autotransfusion, Transfusion Medicine, Faculty of Medicine, University of Málaga, Spain.
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