Platelet utilization in a university hospital
J. McCullough, T. A. Steeper, D. P. Connelly, B. Jackson, S. Huntington and E. P. Scott
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.
Two hundred forty-three patients received 22,717 U of platelets in our
hospital during a three-month period. Those with hematologic diseases
accounted for 43% of the patients but used 86% of the platelets.
Sixty-eight percent of the transfusions were given to prevent bleeding and
32% were given to treat active bleeding. Ninety-two percent of therapeutic
transfusions but only 22% of prophylactic transfusions met guidelines
established by the Transfusion Therapeutics Committee of the University of
Minnesota Hospital and Clinics, Minneapolis. However, 78% of prophylactic
platelet transfusions that did not meet the guidelines involved patients
with at least one clinical factor that their physicians believed placed
them at an increased risk of bleeding. Following this analysis, the
guidelines were modified and applied prospectively to requests for
platelets. This resulted in a 14% decrease in the number of platelet units
used during the following year. We conclude that published recommendations
for platelet transfusions do not reflect the complex nature of many
patients' conditions and that the use of guidelines developed by the
medical staff can alter the use of platelet transfusions.
