Objective: To audit appropriate use of blood products in adult patients.
Design: A cross-sectional study with pre-set criteria.
Setting: Ciudad Hospitalaria 'Dr. Enrique Tejera', the main public tertiary-care hospital in Valencia, Venezuela.
Study participants: We studied 700 adult patients from the Medicine, Surgery, Emergency and Obstetrics departments.
Main outcome measure: Appropriate use of blood products.
Results: Seven hundred patients who had an average of 2.45 transfusions (95% confidence interval = 2.28-2.62) were studied. Prevalence of appropriate use was 51.3% for all departments. Prevalence by department was: 72% for Medicine, 36% for Surgery, 56% for Emergency, and 47% for Obstetrics. The average number of transfusions per subject in each department was: Medicine, 3.41; Surgery, 1.75; Obstetrics, 2.09; and Emergency: 2.81 (F-test: P=0.005). Using the department of Medicine as the reference group, it was found that the departments of Surgery, Emergency and Obstetrics had a higher 'risk' of inappropriate use of transfusions, showing odds ratios of 4.4, 1.38 and 2.79 respectively.
Conclusion: The main conclusions of this study are: (i) the prevalence of the appropriate use of blood products was 51%; (ii) packed red cells and fresh frozen plasma were the blood products with the lowest prevalence of appropriate use; and (iii) none of the departments showed rates of appropriate use of transfusions greater than 80%, implying a higher cost in health care and putting patients at a higher risk for acquiring a transfusion-transmitted disease.