Hunter Mellado R
San Pablo Medical Center, Bayamón, P.R. 00960.
Bol Asoc Med P R. 1997 Jan-Mar;89(1-3):4-8.
The purpose of this paper was to evaluate the trends in the use of blood products in our hospital during the last six years. We selected for the study packed red cells and platelet products since they are the most frequently used, on a unit per unit basis they represent a larger component of the transfusion service budget and finally are the most frequent units involved in transfusion reactions.
The variables in the data bank that were utilized to study included, patients transfused, patients operated, units transfused, units prepared, and units discarded. From these variables we constructed the following new variables, Cross match to Transfusion ratio, units transfused to patients transfused ratio, units transfused to patients operated ratio, and finally patients operated to patients transfused ratio. The data was then organized by year and transported to SPSS software where the null hypothesis was tested through an analysis of the variance (ANOVA).
The number of patients who underwent coronary artery bypass surgery increased over the last six years. An average increase of six additional patients per month was documented. An increase in the total number of packed Red Cells units transfused was seen with a mean of 167 units per month in 1992, 182 units in 1994 and 187 units in 1996. (p = .425). A mean of 45 patients per month were transfused in 1992 as compared to 55 and 56 in 1994 and 1996 respectively. (p = .009). The ratio of patients operated to patients transfused decreased from 1.65 in 1992 to 1.3 and 1.4 in 1992 and 1996. (p = .021) The intensity of Red Cell use in patients undergoing surgery was analyzed by using the ratio of number of red cell units transfused by the number of patients operated and transfused. This ratio was 3.7 in 1992, 3.2 in 1994 and 3.3 in 1996. (p = .032) The use of platelets transfusion in the cardiovascular surgery arena appears to have changed very slightly over the five years in our institution. A non-significant trend in the number of patients who are operated and are transfused with platelets is noted, along with a mild decrease in the intensity of platelet use per patient transfused. NON CARDIOVASCULAR SERVICE: The number of patients transfused with packed Red Cells has not changed significantly in this service since 1992. The mean number of units transfused per month in 1992 and in 1994 was close to 222. In 1996, a mean number of 230 units per month were transfused. (p = .172) The mean number of patients transfused increased slightly from 74.5 patients per month in 1992 to 77.5 in 1994 and 77.7 in 1996. (p = .585) The intensity of Red Cell transfusion support decreased somewhat with 2.98 in 1992 to 2.87 and 2.95 in 1994 and 1996. (p = .806) A marked increase in the number of platelet transfusion was documented. A mean number of 192 units were transfused in 1992 per month as compared to 333 and 360 in 1994 and 1996. (p = .27) This increase in platelet use was associated to an increase in the number of patients who were transfused with 9 per month in 1992 and 16.5 and 16.4 in 1994 and 1996. (p = .005) The mean number of platelet transfused per patient decreased in a non significant fashion with 19.9 units and 20.6 units per transfused patient in 1992 and in 1994 to 19.2 units in 1996. (p = .861).
We have been able to define distinct changes in the trends of blood product utilization in our institution.
本文旨在评估我院过去六年血液制品的使用趋势。我们选择浓缩红细胞和血小板制品进行研究，因为它们是最常用的，按单位计算，它们在输血服务预算中占较大比例，并且最终是输血反应中最常见的单位。
数据库中用于研究的变量包括输血患者、手术患者、输注单位、制备单位和废弃单位。从这些变量中，我们构建了以下新变量：交叉配血与输血比率、输注单位与输血患者比率、输注单位与手术患者比率，以及最后手术患者与输血患者比率。然后按年份整理数据，并传输到SPSS软件中，通过方差分析（ANOVA）对原假设进行检验。
在过去六年中，接受冠状动脉搭桥手术的患者数量有所增加。记录显示平均每月增加6名患者。输注的浓缩红细胞单位总数有所增加，1992年平均每月167单位，1994年为182单位，1996年为187单位。（p = 0.425）1992年平均每月有45名患者接受输血，而1994年和1996年分别为55名和56名。（p = 0.009）手术患者与输血患者的比率从1992年的1.65降至1994年和1996年的1.3和1.4。（p = 0.021）通过使用输注红细胞单位数与手术和输血患者数的比率，分析了手术患者中红细胞的使用强度。该比率在1992年为3.7，1994年为3.2，1996年为3.3。（p = 0.032）在我们机构中，心血管手术领域血小板输注的使用在五年内变化非常小。注意到接受手术并输注血小板的患者数量有不显著的趋势，以及每位输血患者血小板使用强度略有下降。非心血管服务：自1992年以来，该服务中接受浓缩红细胞输血的患者数量没有显著变化。1992年和1994年每月输注的平均单位数接近222。1996年，平均每月输注230单位。（p = 0.172）输血患者的平均数量略有增加，从1992年每月74.5名患者增加到1994年的77.5名和1996年的77.7名。（p = 0.585）红细胞输血支持强度有所下降，1992年为2.98，1994年和1996年分别为2.87和2.95。（p = 0.806）记录显示血小板输注数量显著增加。1992年每月平均输注192单位，而1994年和1996年分别为333单位和360单位。（p = 0.27）血小板使用的增加与输血患者数量的增加相关，1992年每月9名，1994年和1996年分别为16.5名和16.4名。（p = 0.005）每位患者输注的血小板平均数量以不显著的方式下降，1992年和1994年每位输血患者为19.9单位和20.6单位，1996年为19.2单位。（p = 0.861）
我们已经能够确定我院血液制品使用趋势的明显变化。
