PMID- 33764542
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210326
IS  - 1537-2995 (Electronic)
IS  - 0041-1132 (Linking)
VI  - 59
IP  - 8
DP  - 2019 Aug
TI  - A retrospective cost analysis of the frequency and cost of transfusion 
      premedications.
PG  - 2523-2527
LID - 10.1111/trf.15301 [doi]
AB  - BACKGROUND: Acetaminophen and diphenhydramine are routinely administered to 
      prevent febrile non-hemolytic and allergic blood transfusion reactions despite 
      multiple randomized controlled trials demonstrating that this practice lacks 
      efficacy. As a result, patients are exposed to the adverse effects of these 
      medications and their financial burdens with no expected benefit. The aim of this 
      study was to quantify the frequency and cost of transfusion premedications in 
      patients with acute myeloid leukemia (AML). STUDY DESIGN AND METHODS: This was a 
      retrospective study of patients with AML admitted to Vanderbilt University 
      Medical Center (VUMC) for induction chemotherapy between January 2008 and 
      December 2016. Data were collected on the number of platelet and packed red blood 
      cell (PRBC) transfusions each patient received during the initial inpatient 
      encounter for AML, as well as on the administration of premedications prior to 
      each transfusion. RESULTS: During the 9-year study period, 948 AML patients 
      received a total of 19,820 transfusions. Of these, 30% were preceded by oral 
      diphenhydramine, 8% by intravenous diphenhydramine, and 39% by oral 
      acetaminophen. The percentage of patients that received a transfusion preceded by 
      a premedication increased over the study period (p = 0.03), as did the percentage 
      of transfusions preceded by a premedication (p = 0.02). The total unadjusted cost 
      of pre-transfusion medications to the institution during the study period was 
      $50,309.77, or $52.67 per patient with AML. The cost of premedications per 
      patient did not increase over the study period (p = .45). CONCLUSIONS: Routine 
      transfusion premedication administration is common in AML patients and not 
      well-supported by available evidence.
CI  - (c) 2019 AABB.
FAU - Christensen, Bradley W
AU  - Christensen BW
AUID- ORCID: 0000-0003-3279-0257
AD  - Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, 
      Tennessee.
FAU - Rubinstein, Samuel M
AU  - Rubinstein SM
AD  - Division of Hematology and Oncology, Department of Internal Medicine, Vanderbilt 
      University Medical Center, Nashville, Tennessee.
FAU - Bastakoty, Dikshya
AU  - Bastakoty D
AD  - Vanderbilt Institute for Clinical and Translational Research, Nashville, 
      Tennessee.
FAU - Savani, Bipin N
AU  - Savani BN
AD  - Division of Hematology and Oncology, Department of Internal Medicine, Vanderbilt 
      University Medical Center, Nashville, Tennessee.
AD  - Veterans Affairs Medical Center, Nashville, Tennessee.
FAU - Booth, Garrett S
AU  - Booth GS
AD  - Department of Pathology, Microbiology, and Immunology, Vanderbilt University 
      Medical Center, Nashville, Tennessee.
LA  - eng
GR  - VR51670/Vanderbilt Institute for Clinical and Translational Research/
PT  - Journal Article
DEP - 20190409
PL  - United States
TA  - Transfusion
JT  - Transfusion
JID - 0417360
SB  - IM
EDAT- 2019/08/01 00:00
MHDA- 2019/08/01 00:01
CRDT- 2021/03/25 12:56
PHST- 2019/03/12 00:00 [revised]
PHST- 2018/10/12 00:00 [received]
PHST- 2019/03/17 00:00 [accepted]
PHST- 2021/03/25 12:56 [entrez]
PHST- 2019/08/01 00:00 [pubmed]
PHST- 2019/08/01 00:01 [medline]
AID - 10.1111/trf.15301 [doi]
PST - ppublish
SO  - Transfusion. 2019 Aug;59(8):2523-2527. doi: 10.1111/trf.15301. Epub 2019 Apr 9.