Effects of transfusing older red blood cells and platelets on obstetric patient outcomes: A retrospective cohort study

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Obonyo, Nchafatso G
Lu, Lawrence Y
White, Nicole M
Sela, Declan P
Rachakonda, Reema H
Teo, Derek
Tunbridge, Matthew
Sim, Beatrice
See Hoe, Louise E
Fanning, Jonathon P
Tung, John-Paul
McKnoulty, Matthew
Bassi, Gianluigi Li
Suen, Jacky Y
Fraser, John F
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2023
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Abstract

Objective: To investigate associations between transfusion of blood products close to the end of shelf-life and clinical outcomes in obstetric inpatients. Methods: Mortality and morbidity were compared in patients transfused exclusively with red blood cells (RBC) stored for less than 21 days (fresh) versus RBC stored for 35 days or longer (old), and platelets (PLT) stored for 3 days or fewer (fresh) versus 4 days or longer (old) in Queensland, Australia from 2007 to 2013. Multivariable models were used to examine associations between these groups of blood products and clinical end points. Results: There were 3371 patients who received RBC and 280 patients who received PLT of the eligible storage durations. Patients transfused with old RBC received fewer transfusions (2.7 ± 1.8 vs. 2.3 ± 1.0 units; P < 0.001). However, a higher rate of single-unit transfusions was also seen in those patients who exclusively received old RBC (252 [9.3%] vs. 92 [13.7%]; P = 0.003). Comparison of fresh vs. old blood products revealed no differences in the quantities of transfused RBC (9.5 ± 5.9 vs. 9.1 ± 5.2 units; P = 0.680) or PLT (1.5 ± 0.8 vs. 1.4 ± 1.1 units; P = 0.301) as well as the length of hospital stay for RBC (3 [2–5] vs. 3 [2–5] days; P = 0.124) or PLT (5 [4–8] vs. 6 [4–9] days; P = 0.120). Conclusion: Transfusing exclusively older RBC or PLT was not associated with increased morbidity or mortality.

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International Journal of Gynecology & Obstetrics

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© 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Haematology

Reproductive medicine

Science & Technology

Life Sciences & Biomedicine

Obstetrics & Gynecology

blood transfusion

obstetrics

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Obonyo, NG; Lu, LY; White, NM; Sela, DP; Rachakonda, RH; Teo, D; Tunbridge, M; Sim, B; See Hoe, LE; Fanning, JP; Tung, J-P; McKnoulty, M; Bassi, GL; Suen, JY; Fraser, JF, Effects of transfusing older red blood cells and platelets on obstetric patient outcomes: A retrospective cohort study, International Journal of Gynecology & Obstetrics, 2023

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