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Prospective monitoring of plasma and platelet transfusions in a large teaching hospital results in significant cost reduction

Authors

  • Ravindra Sarode,

    1. From the Department of Pathology and Division of Hematology-Oncology, The University of Texas Southwestern Medical Center, and the Department of Pathology, Parkland Health and Hospital System, Dallas, Texas.
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  • Majed A. Refaai,

    1. From the Department of Pathology and Division of Hematology-Oncology, The University of Texas Southwestern Medical Center, and the Department of Pathology, Parkland Health and Hospital System, Dallas, Texas.
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  • Karen Matevosyan,

    1. From the Department of Pathology and Division of Hematology-Oncology, The University of Texas Southwestern Medical Center, and the Department of Pathology, Parkland Health and Hospital System, Dallas, Texas.
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  • James D. Burner,

    1. From the Department of Pathology and Division of Hematology-Oncology, The University of Texas Southwestern Medical Center, and the Department of Pathology, Parkland Health and Hospital System, Dallas, Texas.
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  • Scott Hampton,

    1. From the Department of Pathology and Division of Hematology-Oncology, The University of Texas Southwestern Medical Center, and the Department of Pathology, Parkland Health and Hospital System, Dallas, Texas.
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  • Cynthia Rutherford

    1. From the Department of Pathology and Division of Hematology-Oncology, The University of Texas Southwestern Medical Center, and the Department of Pathology, Parkland Health and Hospital System, Dallas, Texas.
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Ravindra Sarode, MD, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, CS3.114, Dallas, TX 75390-9073; e-mail: ravi.sarode@utsouthwestern.edu.

Abstract

BACKGROUND: Plasma and platelets (PLTs) are often transfused to correct mild to moderately abnormal laboratory values. Our objective was to reduce unnecessary plasma and PLT transfusions to nonbleeding patients by prospective triage and education of end users in evidence-based hemostasis and transfusion medicine practices.

STUDY DESIGN AND METHODS: Using the Parkland Memorial Hospital's transfusion service and admission database as the data source, this study comprises the comparison of transfusion data on plasma and PLT use between pre- (2000-2002) and posttriage (2003-2006) periods. Yearly transfusion and wastage data on red blood cells (RBCs), plasma, and PLTs and yearly hospital admissions, trauma visits, and surgical procedures were extracted retrospectively for the study.

RESULTS: The study revealed that implementation of triage resulted in a significant reduction of plasma (60%) and PLT (25%) transfusions, saving more than $3,000,000 over 4 years.

CONCLUSIONS: Prospective triage and evidence-based transfusion practice education reduced unnecessary plasma and PLT transfusions and health care costs.

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