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Article
April 22, 1988

Platelet Utilization in a University Hospital

Author Affiliations

From the Department of Laboratory Medicine and Pathology (Drs McCullough, Steeper, Connelly, Jackson, and Scott) and Quality Assurance Services (Ms Huntington), University of Minnesota, and American Red Cross Blood Service, St Paul Region (Drs McCullough, Jackson, and Scott), Minneapolis.

From the Department of Laboratory Medicine and Pathology (Drs McCullough, Steeper, Connelly, Jackson, and Scott) and Quality Assurance Services (Ms Huntington), University of Minnesota, and American Red Cross Blood Service, St Paul Region (Drs McCullough, Jackson, and Scott), Minneapolis.

JAMA. 1988;259(16):2414-2418. doi:10.1001/jama.1988.03720160034026
Abstract

Two hundred forty-three patients received 22 717 U of platelets in our hospital during a three-month period. Those with hematologic diseases accounted for 43% of the patients but used 86% of the platelets. Sixty-eight percent of the transfusions were given to prevent bleeding and 32% were given to treat active bleeding. Ninety-two percent of therapeutic transfusions but only 22% of prophylactic transfusions met guidelines established by the Transfusion Therapeutics Committee of the University of Minnesota Hospital and Clinics, Minneapolis. However, 78% of prophylactic platelet transfusions that did not meet the guidelines involved patients with at least one clinical factor that their physicians believed placed them at an increased risk of bleeding. Following this analysis, the guidelines were modified and applied prospectively to requests for platelets. This resulted in a 14% decrease in the number of platelet units used during the following year. We conclude that published recommendations for platelet transfusions do not reflect the complex nature of many patients' conditions and that the use of guidelines developed by the medical staff can alter the use of platelet transfusions.

(JAMA 1988;259:2414-2418)

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