Hoeltge G A, Brown J C, Herzig R H, Johannisson M R, Millward B L, O'Hara P J, Orlowski J P, Sharp D E, Zurick A M
Cleve Clin J Med. 1989 May;56(3):267-72. doi: 10.3949/ccjm.56.3.267.
Comprehensive review of clinical blood transfusion practice at a tertiary-care medical center is complicated by the extraordinary number of patients that receive such therapy. Computer-assisted review of the key objective data used in making the decisions about transfusion is necessary to evaluate the process. Use of 15,873 units of red blood cells, 3,641 units of plasma, 2,619 pools of platelets or pheresis units, and 259 pools of cryoprecipitate was screened by comparing pre-transfusion and post-transfusion blood counts with the medical staff's evaluation criteria. On this basis, 81.4% of transfusion episodes (TEs) were considered fully justified. Medical records were selected for audit from the cases in which the transfusion decisions could not be justified by on-line information. Abstracted data subsequently justified 82 of 139 audited cases; 68.4% of the comments pertaining to the remaining 57 cases adequately explained the transfusion decision. Thus, nearly 96% of the TEs were justifiable as determined by peer review.
在一家三级医疗中心对临床输血实践进行全面审查，因接受此类治疗的患者数量众多而变得复杂。为了评估这一过程，有必要对用于输血决策的关键客观数据进行计算机辅助审查。通过将输血前和输血后的血细胞计数与医务人员的评估标准进行比较，对15873单位红细胞、3641单位血浆、2619单位血小板或单采血小板以及259单位冷沉淀的使用情况进行了筛查。在此基础上，81.4%的输血事件（TEs）被认为是完全合理的。从那些在线信息无法证明输血决策合理的病例中选择医疗记录进行审核。随后，抽取的数据证明139例审核病例中有82例合理；其余57例病例中68.4%的评论充分解释了输血决策。因此，经同行评审确定，近96%的TEs是合理的。
