Background/Case Studies: To assess patient blood management (PBM) practices across the globe, the Association for the Advancement of Blood and Biotherapies (AABB) conducted a survey on PBM in 2022 which was unique due to its transcontinental outreach and served as a worldwide snapshot of the prevalent practices.
Study
Design/Methods: AABB’s Transfusion Safety/PBM subsection formed a workgroup to construct the survey and obtain data for 2021 conducted from May 31, 2022 through June 15, 2022. It was distributed to global AABB hospital members and non-AABB members. As a subset analysis, the North American (NA) responses were compared with the results from AABB’s 2013 Blood Survey.
Results/Findings: Responses were received from 274 facilities including 69 non-NA member responses across 5 WHO regions as compared to 14 non-US member responses in 2013. Globally, 126/274 (45.9%) respondents reported having a PBM program vs NA cohort (2022) 103/205(50.2%) vs. 207/555(37.3%) in 2013. Globally, the PBM programs involved pathologists 71(56.3%), blood bank supervisor/managers 53(42.1%) and transfusion medicine consultants 26(21.1%) with pathologists 70/103(67.9%) highest in the NA cohort. Globally, transfusion thresholds were derived from AABB 205/267(76.8%), College of American Pathologists 111/267(41.6%) and hospital-developed guidelines 119(44.6%) used individually or combined. In the NA cohort, AABB was used by 91/103(88.3%). Out of the 206/274(75.1%) who reported the usage of alternates to blood products, the majority used vitamin K 188(91.2%), tranexamic acid 167(81.1%), and fibrin sealant 85(41.2%). In the NA cohort, 151/205(73.6%) reported similar distribution. Blood is not an option programs (BNAO) were available at 110/273 (40.3%) of respondents’ facilities with the NA cohort having similar results 86/204 (41.9%). Globally, 60/272 (22.1%) had a formal service to manage the patient’s anemia, in the NA cohort (2022) 41/204 (20.0%) vs. 36 /87 (41.4%) in 2013. Regarding the promotion of single-unit transfusions, this was reported globally by 101/126 (80.2%) vs NA cohort (2022) 86/205(41.9%) vs 27/55(52.0%) in 2013. Formal PBM training and education was conducted globally at 62/126 (49.2%) centers vs NA cohort (2022) 47/103(45.6%) vs 366/555(65.9%) in 2013. Conclusions: This global PBM survey captured more facilities outside of the NA than in 2013. The percentage of PBM programs reported has increased since the last survey, however, it is still in a minority of hospitals outside of NA. The majority have implemented transfusion thresholds based upon professional association recommendations and promote single-unit red blood cell transfusions. Areas of improvement (response < 50%) include BNAO programs, anemia management and educational programs which have decreased since the last survey. This survey tells us where we are today and may serve as our roadmap ahead.
Importance of research: This survey gives us the current scenario in patient blood management at global level and may help in guiding our future efforts for improving the implementation of PBM in the world.
