Evaluation of the appropriateness of trombosit suspension replacements in patient blood management

Patient Blood Management (PBM) is an evidence-based medical practice that aims to reduce the need for blood transfusions, minimize blood loss, and allow patients to use their own blood most efficiently, providing a holistic approach to blood transfusions. PBM practices aim to improve patient safety and clinical outcomes by promoting individualized treatment approaches. The purpose of our study is to evaluate the appropriateness of trombosit suspension (PS) transfusions according to PBM guidelines in a university hospital. In this study, patients who received apheresis, pool, and random trombosit suspensions from the Transfusion Center between March 1, 2023, and June 1, 2023, were examined. A total of 701 patients over the age of 18 were included in the study. It was found that a total of 3647 units of trombosit replacement were administered to these 701 patients. The highest number of transfusions was performed in the Hematology Department (43.9%), followed by the Internal Medicine Intensive Care Unit (ICU) with 14.7%. When patients were evaluated according to the diagnoses of the departments they were hospitalized in, it was found that 53.9% of the patients were hospitalized with a diagnosis of hematological or oncological malignancy. In our study, it was found that the most common indication for trombosit suspension (PS) transfusion was thrombocytopenia, with an incidence rate of 57.5%. The average trombosit count before transfusion for patients transfused due to thrombocytopenia was 12x109± 9x109/L. According to the literature, the transfusion threshold for patients without additional findings is set at a platelet count of 10x10⁹/L. However, in our study, 78 patients were identified who received transfusions for thrombocytopenia despite having platelet counts above 20x10⁹/L. Although the majority of transfusions were administered in accordance with standard transfusion guidelines, it was observed that in some departments these principles were not strictly followed, and transfusions were given at higher platelet counts.