Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar;25(3):207-214.
doi: 10.1007/s12471-016-0936-1.

Benchmarking the use of blood products in cardiac surgery to stimulate awareness of transfusion behaviour : Results from a four-year longitudinal study

C Brouwers  1 , B Hooftman  2 , S Vonk  2 , A Vonk  3 , W Stooker  4 , W H Te Gussinklo  5 , R M Wesselink  6 , C Wagner  2   7 , M C de Bruijne  2
Affiliations

Benchmarking the use of blood products in cardiac surgery to stimulate awareness of transfusion behaviour : Results from a four-year longitudinal study

C Brouwers et al. Neth Heart J. 2017 Mar.

Abstract

Introduction: Cardiac operations account for a large proportion of the blood transfusions given each year, leading to high costs and an increased risk to patient safety. Therefore, it is important to explore initiatives to reduce transfusion rates. This study aims to provide a benchmark for transfusion practice by inter-hospital comparison of transfusion rates, blood product use and costs related to patients undergoing coronary artery bypass grafting (CABG), valve surgery or combined CABG and valve surgery.

Methods: Between 2010 and 2013, patients from four Dutch hospitals undergoing CABG, valve surgery or combined CABG and valve surgery (n = 11,150) were included by means of a retrospective longitudinal study design.

Results: In CABG surgery the transfusion rate ranged between 43 and 54%, in valve surgery between 54 and 67%, and in combined CABG and valve surgery between 80 and 88%. With the exception of one hospital, the trend in transfusion rate showed a significant decrease over time for all procedures. Hospitals differed significantly in the units of blood products given to each patient, and in the use of specific transfused combinations of blood products, such as red blood cells (RBCs) and a combination of RBCs, fresh frozen plasma (FFP) and platelets.

Conclusion: This study indicates that benchmarking blood product usage stimulates awareness of transfusion behaviour, which may lead to better patient safety and lower costs. Further studies are warranted to improve awareness of transfusion behaviour and increase the standardisation of transfusion practice in cardiac surgery.

Keywords: Benchmark; Blood products; Blood transfusion; CABG; Cardiac surgery; Valve.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

C. Brouwers, B. Hooftman, S. Vonk, A. Vonk, W. Stooker, W.H. te Gussinklo, R.M. Wesselink, C. Wagner and M.C. de Bruijne declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Figures

Fig. 1
Fig. 1
Trend in transfusion rate of between 2010 and 2013 (CABG, valve surgeries and combined CABG + valve surgeries) (CABG coronary artery bypass graft)
Fig. 2
Fig. 2
Relative number of patients with transfused RBCs, FFP, platelets or combination of these type of blood products in CABG surgery (CABG coronary artery bypass graft, RBC red blood cells, FFP fresh frozen plasma, PLT platelets)
Fig. 3
Fig. 3
Relative number of patients with transfused RBCs, FFP, platelets or combination of these type of blood products in valve surgery (RBC red blood cells, FFP fresh frozen plasma, PLT platelets)
Fig. 4
Fig. 4
Relative number of patients with transfused RBCs, FFP, PLTs or combination of these type of blood products in CABG combined with valve surgery (CABG coronary artery bypass graft, RBC red blood cells, FFP fresh frozen plasma, PLT platelets)
See this image and copyright information in PMC

References

    1. Society of Thoracic Surgeons Blood Conservation Guideline Task Force Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline. Ann Thorac Surg. 2007;83:S27–S86. doi: 10.1016/j.athoracsur.2007.02.099. - DOI - PubMed
    1. Williams ML, He X, Rankin JS, et al. Preoperative hematocrit is a powerful predictor of adverse outcomes in coronary artery bypass graft surgery: a report from the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Ann Thorac Surg. 2013;96:1628–1634. doi: 10.1016/j.athoracsur.2013.06.030. - DOI - PubMed
    1. Society of Thoracic Surgeons Blood Conservation Guideline Task Force 2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg. 2011;91:944–982. doi: 10.1016/j.athoracsur.2010.11.078. - DOI - PubMed
    1. Vonk AB, Meesters MI, van Dijk WB, et al. Ten-year patterns in blood productutilization during cardiothoracic surgery with cardiopulmonary bypass in a tertiary hospital. Transfusion. 2014;54:2608–2616. doi: 10.1111/trf.12522. - DOI - PubMed
    1. Cabana MD, Rand CS, Powe NR, et al. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282:1458–1465. doi: 10.1001/jama.282.15.1458. - DOI - PubMed

LinkOut - more resources