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Table. 2.

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.

§P<0.05, P<0.01, and P<0.001, significant difference between two hospitals.

Abbreviations: HSCT, hematopoietic stem cell transplantation; DIC, disseminated intravascular coagulation; NAIT, neonatal alloimmune thrombocytopenia; ICH, intracranial hemorrhage.

Korean J Blood Transfus 2024;35:33-43 https://doi.org/10.17945/kjbt.2024.35.1.33
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