2015, Number 4
PDF size: 217.29 Kb.
ABSTRACTIntroduction: In transfusion medicine, premedication y a very common practice among physicians. There are a few studies about the economical impact of this practice, even when it is a very common practice and there is not a solid base to prescribe premedication. Objectives: To examine the frequency of transfusional reactions, using of premedication and the cost implications in a 3rd level hospital. Material and methods: A prospective, transversal and observational study where transfusion medicine data was analized from random patients from 2009 to 2011. Results: 927 transfusions in 631 patients were analized from November 2009 to June 2011, with a ratio blood components/patients of 1.46:1. From of all transfusions, just 7 presented a reaction (only 0.75%). The use of premedication was given 33% of patients. Given the unit cost, total cost of $ 56,860 pesos on 313 for 210 patients was obtained. Calculating the cost of approximately 4,386 patients per year, the amount for the hospital this practice would be $ 1’182,834 pesos only in medicine. Conclusions: It was found that by far the practice of premedication exceeds the frequency of transfusion reactions and premedication is performed on patients without history or risk factors to develop a reaction during transfusion.
Ezidiegwu CN, Lauenstein KJ, Rosales LG, Kelly KC, Henry JB. Febrile nonhemolytic transfusion reactions, management by premedication and cost implications in adult patients. Arch Pathol Lab Med. 2004; 128 (9): 991-995.
Patterson BJ, Freedman J, Blanchette V. Effect of premedication guidelines and leukoreduction on the rate of febrile nonhaemolytic platelet transfusion reactions. Transfus Med. 2000; 10: 199-206.
Sanders RP et al. Premedication with acetaminophen or diphenhydramine for transfusion with leucoreduced blood products in children. Br J Haematol. 2005; 130 (5): 781-787.
Goodell PP, Uhl L, Mohammed M, Powers AA. Risk of hemolytic transfusion reactions following emergency-release rbc transfusion. Am J Clin Pathol. 2010; 134 (2): 202-206.
Kennedy LD, Case LD, Hurd DD, Cruz JM, Pomper GJ. A prospective, randomized, double-blind controlled trial of acetaminophen and diphenhydramine pretransfusion medication versus placebo for the prevention of transfusion reactions. Transfusion. 2008; 48 (11): 2285-2291.
Geiger TL, Howard SC. Acetaminophen and diphenhydramine premedication for allergic and febrile non-hemolytic transfusion reactions: good prophylaxis or bad practice? Transfus Med Rev. 2007; 21 (1): 1-12.
King KE, Ness PM. Prevention of febrile nonhemolytic and allergic transfusion reactions with pretransfusion medication: is this evidence-based medicine? Transfusion. 2008; 48 (11): 2285-2291.
Wang SE, Lara PN Jr, Lee-Ow A, Reed J, Wang LR, Palmer P et al. Acetaminophen and diphenhydramine as premedication for platelet transfusions: a prospective randomized double-blind placebo-controlled trial. Am J Hematol. 2002; 70 (3): 191-194.