Are we transfusing right? A retrospective study on appropriateness of pediatric blood transfusions

Objectives: The objective of the study is to analyze the blood component transfusions and interpret the appropriateness of the transfusions over 6 months in a tertiary care teaching hospital. Materials and Methods: A retrospective, cross-sectional, analytical study of blood transfusions in pediatric patients <18 years of age was conducted in a regional blood center at a tertiary care hospital in South India. Patient’s data were analyzed and indications for transfusion were reviewed in detail in accordance with the British Committee for Standards in Hematology and Association for the Advancement of Blood and Biotherapies (AABB) guidelines and interpreted as appropriate and inappropriate. Statistical analysis: Chi-square test and Chi-square test with Yates correction were used to compare different categories of independent variables with the outcome variable (appropriateness of transfusion) as applicable. P < 0.05 was considered to be statistically significant. Results: Of total 5323 transfusions, 92 were packed red blood cells (74 appropriate), 49 were fresh frozen plasma (FFP) (40 appropriate), 21 were cryoprecipitate (12 appropriate), 21 were random donor platelets (21 appropriate), two were single donor platelets (2 appropriate), and one whole blood transfusion (1 appropriate) with a P = 0.02 when analyzed for appropriateness based on standard guidelines. Conclusions: Retrospective analysis of blood component therapy in the pediatric age group performed in a tertiary care hospital for various indications proves a statistically significant number of transfusions to be inappropriate. Hence, we emphasize raising awareness among clinicians and primary care providers to perform prudent transfusions strictly adhering to guidelines to ensure the best transfusion practices beneficial to patients.