Le Niger C, Magne Tagne N, Gentric A
Unité d'hémovigilance, hôpital Morvan, CHRU de Brest, 5, avenue Foch, 29609 Brest cedex, France.
Service de médecine interne gériatrique, hôpital La Cavale-Blanche, CHRU de Brest, boulevard Tanguy-Prigent, 29609 Brest cedex, France.
Transfus Clin Biol. 2018 Feb;25(1):49-57. doi: 10.1016/j.tracli.2017.10.003. Epub 2017 Nov 21.
Red blood cell transfusion is commonly required for elderly patients with little specific guidelines for this population. We wished to study the transfusion practices for patients aged≥75 years transfused with red blood cells in all units of our institution. The aim of this work is to describe this population of patients and to compare the transfusion practices to the HAS and ANSM guidelines published in 2014.
An observational study was performed including patients≥75 years, transfused with red blood cells between 27th January to 27th March 2014. Analysis of data included the patients' typology, the characteristics of anemia, the indications and transfusion practices, and the adequation with the guidelines.
Two hundred and forty-one patients were transfused during the period with 422 transfusion episodes (mean age 83±5.2 years, sex-ratio women/men 1.4 with 4.4±2 pathologies and 6.7±3.2 treatments). Only 4.5% of the patients were transfused in geriatric wards. In 61% of the cases, the anemia is acute and chronic in 39%. Fatigue was reported in 50.6% of the cases and dyspnee in 31.7%. A percentage of 31.1 of the patients were prescribed furosemide for transfusion. The mean transfusion recovery was 1.2±0.5g/dL. Two adverse events were reported. Overall, only 10.4% of the prescriptions were not compliant with the guidelines of 2014.
In this study, we describe transfusion practices for patients aged≥75 years. Although the non-compliance with the guidelines is weak, it is possible to improve the transfusion practices taking care of the geriatric characteristics. Prospective studies on a larger scale have to be done to converge on a more consensual management.
