Based on data from the National Inpatient Sample from 1993 through 2014, hospitalized patients receiving at least one unit of red blood cells (RBCs) peaked in 2011 at 6.8% and has been declining steadily; in 2014 only 5.7% of hospitalized patients received a RBC transfusion (p<0.001). This trend was consistent across different ethnicities, illness severity, admission and payment types, and both sexes; however, prevalence of RBC transfusions in children did not decrease over time. Plasma transfusions followed a similar trend, declining from 1.0% of hospitalized patients in 2011 to 0.87% in 2014 (p=0.003). However, platelet transfusions have been holding steady during this same period. Decreases in RBC and plasma transfusions are likely multifactorial including publication of clinical guidelines and trials promoting the safety of a restricted transfusion practices, implementation of patient blood management and conservation programs, and advocacy of medical societies.
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