Department of Health Metric Sciences, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States.
Department of Health Metric Sciences, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, United States.
Transfus Apher Sci. 2021 Feb;60(1):103012. doi: 10.1016/j.transci.2020.103012. Epub 2020 Nov 21.
Better understanding of blood usage rates could identify trends in transfusion practices over time and inform more efficient management.
Inpatient admissions from the Healthcare Cost and Utilization Project National Inpatient Sample and State Inpatient Databases were analyzed for packed red blood cell (PRBC), plasma, platelet, and whole blood (WB) transfusions. The transfusion rates per admission and per prevalent case were calculated. Prevalence estimates were from the Global Burden of Disease 2017 study (GBD).
From 2000 to 2014, blood usage rates for most causes peaked around 2010. Across all causes, PRBC were the most commonly transfused component, followed by plasma, platelets, and WB. However, the relative use of each type varied by cause. Nutritional deficiencies (1.75 blood product units across all components per admission; 95 % uncertainty interval (UI) 1.62-1.87), neoplasms (0.95; 0.87-1.04), and injuries (0.92; 0.86 - 0.98) had the greatest blood use per admission. Cardiovascular diseases (96.9 units per 1000 prevalent cases; 89.3-105.0) and neoplasms (92.7 units per 1000 prevalent cases; 84.3-101.5) had the greatest blood use per prevalent case. Across all admissions, over three million blood units were saved in 2014 compared to 2011 due to transfusing at a reduced rate.
Blood transfusion rates decreased from 2011 to 2014 in the United States. This decline occurred in most disease categories, which points towards broad strategies like patient blood management systems and disease specific improvements like changes in surgical techniques being effective.
更好地了解血液使用情况的变化趋势，可以发现一段时间内输血实践的变化，并为更有效的管理提供信息。
从医疗保健成本和利用项目国家住院患者样本和州住院患者数据库中分析了用于输血的浓缩红细胞（PRBC）、血浆、血小板和全血（WB）。每例入院和每例现患病例的输血率均进行了计算。现患病例的估计值来自 2017 年全球疾病负担研究（GBD）。
从 2000 年到 2014 年，大多数原因的血液使用量在 2010 年左右达到峰值。在所有原因中，PRBC 是最常用的输血成分，其次是血浆、血小板和 WB。然而，每种类型的相对使用情况因病因而异。营养缺乏症（每例入院的所有成分中均有 1.75 个单位的血液产品；95%置信区间[CI]为 1.62-1.87）、肿瘤（0.95；0.87-1.04）和损伤（0.92；0.86-0.98）每例入院时的血液使用量最大。心血管疾病（每 1000 例现患病例 96.9 个单位；89.3-105.0）和肿瘤（每 1000 例现患病例 92.7 个单位；84.3-101.5）每例现患病例的血液使用量最大。与 2011 年相比，2014 年因输血率降低，全美共节省了超过 300 万个单位的血液。
美国 2011 年至 2014 年期间，输血率有所下降。这种下降发生在大多数疾病类别中，这表明像患者血液管理系统这样的广泛策略和像手术技术改变这样的疾病特异性改进是有效的。
