
Appropriateness of platelet transfusion episodes according to the indication at each hospital
Indication (target of minimum platelet count) | N (%) of indications in each transfusion episode | N (%) of appropriate platelet transfusion episodes | |||
---|---|---|---|---|---|
Hospital A | Hospital B | Hospital A | Hospital B | ||
Clinical judgments (regardless of platelet count) | |||||
A tendency toward a decreased platelet count | 14 (4.7)§ | 29 (2.5)§ | 14 (100) | 29 (100) | |
An abnormal platelet count or aberrant platelet function attributable to fever, leukocytosis, coagulopathy, chemotherapy, or drug use | 0 (0) | 4 (0.3) | - | 4 (100) | |
A decision made when a quick blood test was not available | 11 (3.7)¶ | 1 (0.1)¶ | 11 (100) | 1 (100) | |
Sustained bleeding despite platelet transfusion | 1 (0.3) | 2 (0.2) | 1 (100) | 2 (100) | |
Outpatient status | 1 (0.3)¶ | 145 (12.4)¶ | 1 (100) | 145 (100) | |
Total | 27 (9.0)∥ | 181 (15.5)∥ | 27 (100) | 181 (100) | |
Therapeutic purpose | |||||
Control of active bleeding that was not critical bleeding (50×109/L) | 139 (46.5)¶ | 124 (10.6)¶ | 125 (89.9) | 107 (86.3) | |
Control of critical bleeding (100×109/L)* | 25 (8.4)¶ | 27 (2.3)¶ | 24 (96.0) | 26 (96.3) | |
Total | 164 (54.8)¶ | 151 (12.9)¶ | 149 (90.9) | 133 (88.1) | |
Prophylaxis for patients at risk for spontaneous bleeding | |||||
Patients with hematologic diseases (10∼20×109/L) | 0 (0)¶ | 537 (45.9)¶ | - | 403 (75.0) | |
Patients with solid tumors (10∼20×109/L) | 0 (0)¶ | 90 (7.7)¶ | - | 25 (27.8) | |
Patients undergoing HSCT (10∼20×109/L) | 0 (0)¶ | 60 (5.1)¶ | - | 25 (41.7) | |
Patients with DIC (50×109/L) | 50 (16.7)¶ | 84 (7.2)¶ | 43 (86.0)§ | 81 (96.4)§ | |
Stable neonates (20∼25×109/L) | 2 (0.7)§ | 0 (0)§ | 2 (100) | - | |
Neonates with NAIT and ICH (50∼100×109/L) | 16 (5.4)¶ | 0 (0)¶ | 16 (100) | - | |
Other | 15 (5.0)¶ | 0 (0)¶ | 6 (40.0) | - | |
Total | 83 (27.8)¶ | 771 (65.8)¶ | 67 (80.7)§ | 534 (69.3)§ | |
Prophylaxis before surgery or procedures | |||||
Elective surgery or general procedures (50×109/L)† | 17 (5.7) | 58 (5.1) | 11 (64.7) | 41 (70.7) | |
Surgery during which bleeding might trigger critical organ damage or that was life-threatening (100×109/L)‡ | 7 (2.3)∥ | 4 (0.3)∥ | 7 (100) | 4 (100) | |
Other | 1 (0.3) | 6 (0.5) | 0 (0) | 0 (0) | |
Total | 25 (8.4) | 68 (5.8) | 18 (72.0) | 45 (66.2) | |
Grand total | 299 (100) | 1,171 (100) | 261 (87.3)¶ | 893 (76.3)¶ |
*Including retinal and central nervous system bleeding and bleeding caused by multiple trauma.
†Lumbar puncture, thoracocentesis, paracentesis, fine-needle aspiration, tooth extraction, endoscopic biopsy, transbronchial biopsy, delivery, surgery with cardiopulmonary bypass, and insertion of a central venous catheter.
‡Neurosurgery, ophthalmic surgery, extensive adhesiolysis, microvascular bleeding, massive transfusions due to multiple trauma or central nervous system injuries, and hematomas that imposed pressure on the airway.
§
Abbreviations: HSCT, hematopoietic stem cell transplantation; DIC, disseminated intravascular coagulation; NAIT, neonatal alloimmune thrombocytopenia; ICH, intracranial hemorrhage.