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Evaluating compliance with restrictive blood transfusion practices: A 5‐year study from a Greek tertiary hospital

Year: 2026

Type: article

Abstract: BACKGROUND AND OBJECTIVES: Our aim was to retrospectively assess the adherence to a restrictive transfusion strategy (in the context of patient blood management [PBM]) among patients in a Greek tertiary hospital over a 5-year period (2020-2024) following the initial evaluation of the electronic transfusion request system. MATERIALS AND METHODS: Analyses included assessment of time trends-overall and by hospital clinic-in haemoglobin (Hb) levels at transfusion, as well as in the proportion of inappropriate transfusions, based on pre-specified audit criteria (Hb thresholds for red blood cell transfusions). RESULTS: A total of 23,322 transfusion episodes were recorded among medical patients, with annual counts ranging from 4078 to 5394 and an overall mean transfusion Hb level of 7.18 ± 0.78 g/dL. The proportion of transfusions with Hb levels above 7.00 g/dL decreased significantly from 69.14% in 2020 to 58.83% in 2023 (Cochran-Armitage test for trend, p < 0.01). Among patients without comorbidities (threshold: 7.00 g/dL), 53.34% of transfusions occurred above this cut-off, with an initial drop from 60.41% in 2020 to 47.72% in 2021, followed by a rebound to 58.43% in 2024 (p = 0.25). Transfusions above 8.00 g/dL also declined significantly, from 8.33% in 2020 to 5.20% in 2023 (p < 0.01). Differences were also observed among clinics. CONCLUSION: Overall, moderate compliance with the restrictive transfusion strategy was observed. The initial decline in transfusions above prespecified Hb thresholds followed by fluctuations in subsequent years highlights the need for a consistent, multifaceted effort to optimize blood usage.

Source: Vox Sanguinis

DOI: 10.1111/vox.70184