Survey of provider transfusion practices for oncology patients in an Academic Medical Center

Ryan J. Buck*, Kelley N. Wachsberg, A. Charlotta Weaver, Luke O Hansen, Brandon J. Mcmahon, Lyndsey Dombrowski, Kevin J. O'Leary

*Corresponding author for this work

Research output: Contribution to journalReview article

1 Scopus citations

Abstract

Objectives Hospitalized oncology patients receive care from a variety of professionals, each of whom plays a role in decisions related to blood transfusions. We sought to examine differences in transfusion practices based on professional role, years of experience, and patient clinical scenario. Methods We surveyed general medicine residents, hospitalists, and oncologists caring for inpatients at a large academic medical center between August 2013 and June 2014. Respondents reported transfusion practices in three different patient scenarios: a generally healthy patient, a patient with solid tumor malignancy, and a patient with hematologic malignancy. We also assessed rationale for transfusion practices. Bivariate comparisons of respondent characteristics and transfusion threshold were conducted using the Fisher exact test. Multivariate logistic regression was performed to assess the relative relations among professional role, years in practice, clinical scenario, and transfusion threshold <7 g/dL. Results Of 158 physicians surveyed, 97 responded (61.4%). In bivariate analyses, fewer oncologists than residents or hospitalists used a threshold of <7 g/dL, but the result was significant for only one of three scenarios. The multivariate odds of transfusing at a threshold <7 g/dL were significantly higher among nononcologists (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.03-4.28). Residents and practitioners in practice for <4 years also were more likely to use a threshold <7 g/dL (OR 1.82, 95% CI 0.99-3.33). Providers were less likely to use a restrictive threshold when an underlying malignancy was present (solid tumor OR 0.31, 95% CI 0.15-0.64; hematologic malignancy OR 0.34, 95% CI 0.16-0.70). Conclusions Transfusion thresholds differed based on professional role, years in practice, and patient scenario. Further research is needed to determine the optimal transfusion threshold for oncology patients.

Original languageEnglish (US)
Pages (from-to)267-271
Number of pages5
JournalSouthern Medical Journal
Volume109
Issue number4
DOIs
StatePublished - Apr 1 2016

Keywords

  • anemia
  • blood transfusions
  • guidelines
  • malignancy
  • quality

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'Survey of provider transfusion practices for oncology patients in an Academic Medical Center'. Together they form a unique fingerprint.

  • Cite this