Trends in cryoprecipitate transfusion in the United States

BACKGROUND: National trends in cryoprecipitate transfusion and patient- and hospital-level factors associated with cryoprecipitate transfusion use among US hospitalizations are not well characterized. STUDY DESIGN AND METHODS: This descriptive study used the National Inpatient Sample (NIS) to estimate overall and sex-specific trends in cryoprecipitate transfusion from 2016 to 2022. Adult hospitalizations (≥18 years) receiving cryoprecipitate were included. The unit of analysis was the hospitalization record, and sampling weights were applied to produce nationally representative estimates. Factors associated with cryoprecipitate transfusion in 2022 were evaluated using multivariable Poisson regression. RESULTS: Between 2016 and 2022, there were 205,075,194 weighted hospitalizations, of which 181,950 (0.089%) involved cryoprecipitate transfusion. The prevalence of cryoprecipitate transfusion increased significantly from 0.063% in 2016 to 0.110% in 2022. In multivariable analysis, cryoprecipitate transfusion was more likely among patients aged 60-70 years (vs. 18-30 years; adjusted prevalence ratio [adjPR] = 2.34 [95% confidence intervals (CI) = 2.03-2.70]). Transfusion was also associated with non-White patients, those from higher-income areas, elective admissions (vs. nonelective admissions; adjPR = 1.48 [95% CI = 1.32-1.66]), larger hospital bed size (vs. small; adjPR = 2.71 [95% CI = 2.14-3.43]), and in metropolitan teaching hospitals (vs. nonteaching; adjPR = 3.04 [95% CI = 2.50-3.69]). The prevalence of cryoprecipitate transfusion was lower among females (adjPR = 0.59 [95% CI = 0.55-0.62]), Medicare-covered hospitalizations (vs. Private; adjPR = 0.85 [95% CI = 0.78-0.93]), and admission to private investor-own hospitals (vs. government nonfederal hospitals; adjPR = 0.56 [95% CI = 0.36-0.87]). DISCUSSION: Cryoprecipitate transfusion among US hospitalizations increased from 2016 to 2022, reflecting evolving transfusion practices and the need for continued evaluation of fibrinogen replacement strategies and appropriate cryoprecipitate utilization.