Comprehensive patient blood management program can reduce use of transfusions, improve patient outcomes

A growing number of hospitals have implemented patient blood management programs to reduce unnecessary blood transfusions and costs. A study published in Mayo Clinic Proceedings finds that such a program can not only substantially reduce transfusion use, but also reduce the length of hospital stays and in-hospital adverse outcomes. was then matched (1:2 ratio) with a SARS-CoV-2–negative patient of the same ASA physical status classification and similar age who was undergoing a similar procedure. The two groups were also comparable on baseline demographics, sex and body weight.

The observational study reviewed 400,998 hospital admissions from 2010 to 2018 at two Mayo Clinic hospital campuses. Allogenic transfusion use—meaning transfusions where the patient receives donated blood—and clinical outcomes were assessed, and during the study time frame, allogenic transfusions decreased from 607 to 405 per 1,000 admissions. Transfusion reductions were noted across medical and surgical admissions and for all major surgery types except liver transplantation, which were unchanged. Hospital length of stay and adverse events were lower than projected.

Reducing or eliminating unnecessary allogenic transfusions is increasingly important at a time when donor blood is in short supply, as has been true during the COVID-19 pandemic. Unnecessary transfusions also are associated with poor patient outcomes, according to the study.

“These efforts were associated with substantial reductions in transfusion utilization, including an absolute risk reduction of 6% for receiving any transfusion during hospitalization and an approximate 25% reduction in the number of blood products transfused beyond projections,” says Matthew Warner, M.D., an anesthesiologist and critical care physician at Mayo Clinic, who is first author of the study. “We also observed a modest decrease in adverse events during hospitalization, such as myocardial infarction, stroke, venous thromboembolism, acute respiratory failure, and transfusion reactions.”

Peter Wu’s MD FASA Take: A summary of a recent paper in Mayo Clinic Proceedings about the benefits of setting up an inpatient blood management program. This is a fairly straightforward-to-implement process improvement project, initiated by your anesthesia group, that yields rapid results for your hospital partner.