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

• Published in: International journal of gynecology and obstetrics Vol. 164; no. 1; pp. 184 - 191
• Main Authors: 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.
• Format: Journal Article
• Language: English
• Published: United States 01.01.2024
• Subjects: Australia; Blood Platelets; blood transfusion; Erythrocyte Transfusion; Erythrocytes; Humans; obstetrics; platelet transfusion; red blood cells/erythrocyte transfusion; Retrospective Studies; uterine hemorrhage; Australia; blood transfusion; uterine hemorrhage; obstetrics; red blood cells/erythrocyte transfusion; platelet transfusion
• ISSN: 0020-7292; 1879-3479; 1879-3479
• DOI: 10.1002/ijgo.14997

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. Synopsis Transfusing older red blood cells (≥35 days) or platelets (≥4 days) was not associated with worse outcomes in obstetric patients in Queensland.