Red blood cell usage in a tertiary care hospital during the COVID-19 pandemic

Background

The COVID-19 pandemic has led to a social and economic crisis with far-reaching effects on the health care system as well. The pandemic has affected the blood supply, whereas there is limited data on changes in red blood cell requirements and clinical usage patterns during the pandemic.

Methods

The University Hospital Erlangen is a 1400-bed tertiary care hospital. Here, all relevant data for interpreting patterns in the use of blood components are continuously collected since 2010. We are able to integrate the clinical data warehouse components of RBC recipients' personal data, German Diagnosis Related Group (G-DRG) system codes of inpatients, ICD codes, OPS codes, and RBC component data from the blood bank IT system. The obtained DRGs, IDC codes, and OPS codes are associated with the data of the blood component consumption on an individual basis. We analyzed red blood cell usage patterns in 2018 and 2019, the two years before the pandemic, and 2020 and 2021, the first two years of the pandemic.

Results

In 2020, there was no significant change in red cell usage patterns throughout the whole hospital (15,378 RBC units vs. 15.468 units in 2019 and 15.189 units in 2018). Among pre-MDC DRGs for ventilated patients, there was no enhancement in RBC usage. In 2021, there was a 8.2 percent decline in RBC usage in comparison to 2020. Interestingly, the number of RBCs per transfusion recipient declined from 4.42 in 2019 to 4.19 and 4.06 in 2020 and 2021, respectively. Overall, the long-term trends of previous years with decreasing use of RBCs in internal medicine and increasingly cautious indications continued during the pandemic.

Conclusion

The COVID-19 pandemic has impacted the blood supply, resulting in unprecedented blood shortages, particularly during the summer months of the last two years. Obviously, this exacerbated the trend toward a reduction in RBCs actually consumed per patient in need of transfusion more than changes in clinical demand.

Offenlegung Interessenkonflikt:

There are no conflicts of interest.