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; La Tonya J. Hickson; Amy W. Williams; David Dingli; James T. McCarthy

doi:10.1159/000445447

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, La Tonya J. Hickson, Amy W. Williams, David Dingli, James T. McCarthy

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

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 language	English (US)
Pages (from-to)	23-34
Number of pages	12
Journal	Nephron
Volume	133
Issue number	1
DOIs	https://doi.org/10.1159/000445447
State	Published - Jun 1 2016

Keywords

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

ASJC Scopus subject areas

Nephrology
Physiology (medical)
Urology
Physiology

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10.1159/000445447

Cite this

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

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.",

keywords = "Anemia, Chronic hemodialysis, End-stage renal disease, Red blood cell transfusions",

author = "Albright, {Robert C.} and Dillon, {John J.} and Hocum, {Craig L.} and Stubbs, {James R.} and Johnson, {Pamela M.} and Hickson, {La Tonya J.} and Williams, {Amy W.} and David Dingli and McCarthy, {James T.}",

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year = "2016",

month = jun,

day = "1",

doi = "10.1159/000445447",

language = "English (US)",

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T1 - Total red blood cell transfusions for chronic hemodialysis patients in a Single Center, 2009-2013

AU - Albright, Robert C.

AU - Dillon, John J.

AU - Hocum, Craig L.

AU - Stubbs, James R.

AU - Johnson, Pamela M.

AU - Hickson, La Tonya J.

AU - Williams, Amy W.

AU - Dingli, David

AU - McCarthy, James T.

PY - 2016/6/1

Y1 - 2016/6/1

N2 - 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.

AB - 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.

KW - Anemia

KW - Chronic hemodialysis

KW - End-stage renal disease

KW - Red blood cell transfusions

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

Abstract

Keywords

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