The epidemiology of blood component transfusion in Catalonia, Northeastern Spain

Background: Epidemiologic information on blood component usage can help improve the utilization of transfusion resources.

Study design and methods: Crosssectional survey in 2007 that included every hospital in Catalonia. Clinical data of blood recipients, including the four-digit International Classification of Diseases, 9th Revision, Clinical Modification codes and the indication for transfusion, were prospectively collected according to an established protocol.

Results: In total, 19,148 red blood cell (RBC) units, 1812 platelet (PLT) doses, and 3070 plasma units, transfused into 8019 patients (median age, 71 years; 52% males), were surveyed. Half the RBC units were used by patients older than 70 years. Specific diagnosis and procedures with the highest RBC use were lower limb orthopedic surgery (10.6% of all units) and gastrointestinal hemorrhage (6%). Therapeutic plasmapheresis (8.1%) and heart valve surgery (7.2%) were the procedures with the highest plasma use. Oncohematology patients accounted for 73% of transfused PLTs, more that two-thirds being administered for hemorrhage prophylaxis. Acute hemorrhage was the most common indication for RBC and plasma transfusion. Among all blood recipients, 80% received only RBCs and 6.9% received only plasma and/or PLTs, without concomitant RBCs. The population transfusion incidence rates were 35 RBC units, three PLT doses, and 6 plasma units per 1000 population-year. Demographic changes anticipate a 30% increase in RBC transfusion by year 2030.

Conclusions: These results allow for identification of blood uses that are susceptible to improvement, help appraise the expected yield of blood safety measures, and will assist in planning the future blood supply.