Total red blood cell transfusions for chronic hemodialysis patients in a Single Center, 2009-2013

Robert C. Albright, John J. Dillon, Craig L. Hocum, James R. Stubbs, Pamela M. Johnson, LaTonya Hickson, Amy W. Williams, David M Dingli, James T. McCarthy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Anemia management in chronic hemodialysis (HD) has been affected by the implementation of the prospective payment system (PPS) and changes in clinical guidelines. These factors could impact red blood cell (RBC) transfusion in HD patients. Our distinctive care system contains complete records for all RBC transfusions among our HD patients. Aims: To determine RBC transfusions in patients with prevalent chronic HD, site of administration (inpatient or outpatient), and ordering physician specialty for inpatients; compare pre- and post-PPS RBC transfusions; and compare RBC transfusions during changes in desired outpatient hemoglobin (Hb) range for patients with chronic HD. Methods: Retrospective analysis of medical and blood bank records for patients with prevalent chronic HD July 2009 through June 2013. Results: In total, 310-356 patients were studied. Mean (SD) units of RBCs per 100 patients per month for the study's 48 months were outpatient, 2.6 (1.5), and inpatient, 9.4 (4.6). Outpatient pre-PPS RBC units transfused were 2.1 (0.6) vs. post-PPS of 2.6 (1.5; p = 0.22, t test); for inpatients pre-PPS, 7.9 (4.5) RBC units per month vs. post-PPS, 11.5 (5.1; p = 0.11, t test). Inpatient RBC transfusions accounted for 75.2% (14.2%) of all RBC transfusions; 67.3% (16.3%) of inpatient transfusions were ordered by nonnephrologists. Changes in desired Hb range for outpatient HD patients did not lead to changes in RBC transfusions. Conclusions: No changes in RBC transfusions occurred among our patients with chronic HD with PPS implementation and in desired Hb range during the study period. Most transfusions were given in inpatient settings by nonnephrologists.

Original languageEnglish (US)
Pages (from-to)23-34
Number of pages12
JournalNephron
Volume133
Issue number1
DOIs
StatePublished - Jun 1 2016

Fingerprint

Erythrocyte Transfusion
Prospective Payment System
Renal Dialysis
Inpatients
Outpatients
Hemoglobins
Erythrocytes
Blood Banks
Anemia
Guidelines
Physicians

Keywords

  • Anemia
  • Chronic hemodialysis
  • End-stage renal disease
  • Red blood cell transfusions

ASJC Scopus subject areas

  • Physiology
  • Nephrology
  • Urology
  • Physiology (medical)

Cite this

Albright, R. C., Dillon, J. J., Hocum, C. L., Stubbs, J. R., Johnson, P. M., Hickson, L., ... McCarthy, J. T. (2016). Total red blood cell transfusions for chronic hemodialysis patients in a Single Center, 2009-2013. Nephron, 133(1), 23-34. https://doi.org/10.1159/000445447

Total red blood cell transfusions for chronic hemodialysis patients in a Single Center, 2009-2013. / Albright, Robert C.; Dillon, John J.; Hocum, Craig L.; Stubbs, James R.; Johnson, Pamela M.; Hickson, LaTonya; Williams, Amy W.; Dingli, David M; McCarthy, James T.

In: Nephron, Vol. 133, No. 1, 01.06.2016, p. 23-34.

Research output: Contribution to journalArticle

Albright, RC, Dillon, JJ, Hocum, CL, Stubbs, JR, Johnson, PM, Hickson, L, Williams, AW, Dingli, DM & McCarthy, JT 2016, 'Total red blood cell transfusions for chronic hemodialysis patients in a Single Center, 2009-2013', Nephron, vol. 133, no. 1, pp. 23-34. https://doi.org/10.1159/000445447
Albright, Robert C. ; Dillon, John J. ; Hocum, Craig L. ; Stubbs, James R. ; Johnson, Pamela M. ; Hickson, LaTonya ; Williams, Amy W. ; Dingli, David M ; McCarthy, James T. / Total red blood cell transfusions for chronic hemodialysis patients in a Single Center, 2009-2013. In: Nephron. 2016 ; Vol. 133, No. 1. pp. 23-34.
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abstract = "Background: Anemia management in chronic hemodialysis (HD) has been affected by the implementation of the prospective payment system (PPS) and changes in clinical guidelines. These factors could impact red blood cell (RBC) transfusion in HD patients. Our distinctive care system contains complete records for all RBC transfusions among our HD patients. Aims: To determine RBC transfusions in patients with prevalent chronic HD, site of administration (inpatient or outpatient), and ordering physician specialty for inpatients; compare pre- and post-PPS RBC transfusions; and compare RBC transfusions during changes in desired outpatient hemoglobin (Hb) range for patients with chronic HD. Methods: Retrospective analysis of medical and blood bank records for patients with prevalent chronic HD July 2009 through June 2013. Results: In total, 310-356 patients were studied. Mean (SD) units of RBCs per 100 patients per month for the study's 48 months were outpatient, 2.6 (1.5), and inpatient, 9.4 (4.6). Outpatient pre-PPS RBC units transfused were 2.1 (0.6) vs. post-PPS of 2.6 (1.5; p = 0.22, t test); for inpatients pre-PPS, 7.9 (4.5) RBC units per month vs. post-PPS, 11.5 (5.1; p = 0.11, t test). Inpatient RBC transfusions accounted for 75.2{\%} (14.2{\%}) of all RBC transfusions; 67.3{\%} (16.3{\%}) of inpatient transfusions were ordered by nonnephrologists. Changes in desired Hb range for outpatient HD patients did not lead to changes in RBC transfusions. Conclusions: No changes in RBC transfusions occurred among our patients with chronic HD with PPS implementation and in desired Hb range during the study period. Most transfusions were given in inpatient settings by nonnephrologists.",
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