From Guidelines to Practice: Platelet Transfusions Under the Lens
Sheharyar Raza, Transfusion Medicine Specialist at the University Health Network, shared on LinkedIn:
“With the recent publication of international platelet transfusion guidelines, it’s a good time to ask whether clinical practice lives up to evidence.
Our group, lead by Dr. Sarah Ryan, looked at platelet transfusion practice in a sample of >800k admissions at 22 hospitals over a 5-year period in the GEMINI dataset. Findings now out in British Journal of Haematology
Some highlights:
1) Guideline adherence was higher at academic compared with community hospitals
2) Patients with immune thrombocytopenias (ITP/TTP/HIT) sometimes receive prophylactic platelet transfusions (needs further digging, this shouldn’t be happening)
3) Hematology-oncology physicians had the highest guideline compliance and surgical specialists had the lowest (at least when judged using platelet counts)
A key, non-obvious innovation of this study is a very thoughtful electronic definition of guideline compliance, crafted via input from a diverse panel of experts.
We hope these findings motivate randomized trials, inform quality improvement, and serve as a benchmark for similar future practice audits.
Title: Opportunities for improving platelet transfusion practice: A large retrospective audit across 22 hospitals
Authors: Sarah Ryan, Yang Liu, Sheharyar Raza, Anne Loeffler, Nicole Relke, Nadia Gabarin, Malcolm Risk, Phuong Uyen Nguyen, Na Li, Amol Verma, Fahad Razak, Keyvan Karkouti, Janique Dyba, Donald Arnold, Jeannie Callum.
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