< Blood Service News - 07.06.2010

The majority of blood components are used in surgical operations

Due to a comparatively higher requirement for surgery among those aged 45 or over, a greater amount of blood components is used in patient care for this age group. Blood components are used in the treatment of cancer, cardiovascular diseases and conditions affecting the digestive system in particular. This information has been collected from the VOK database, which holds data on blood component usage in hospitals.

At the FRCBS, donor blood is separated into three components – red cells, platelets and plasma. On an annual basis, the FRCBS supplies hospitals with approximately 250,000 red cell components and 40,000 platelet products (produced of 160,000 platelet components). Additionally, 50,000 units of medicinal plasma products, such as fresh frozen plasma (FFP), are distributed to hospitals every year.

Blood product consumption many times greater amongst older members of the population

Statistically, just over one in three patients receiving blood transfusions is over 65 years old, and close to one third are aged between 45 and 64.

Operations, which generally require large amounts of red cell components, increase in frequency after middle-age, while platelets are primarily used in the treatment of cancer.

Amongst the middle-aged population, the number of surgical operations, organ transplants and cancer treatments is many times that of the younger population. Treatment of the musculoskeletal system, such as hip replacement operations, is more common among older patients.

In relative terms, blood components are seldom used in the treatment of young patients. An exception to this lies in newborns and babies under one year of age, who receive blood transfusions for the treatment of anaemia or to secure other bodily functions. For example, a significant amount of blood components is required for the treatment of premature babies. The treatment of paediatric and adolescent leukaemia also requires blood components, particularly platelets.

Around the age of 30, a significant difference arises in blood component consumption between men and women. Transfusions are sometimes needed in connection with giving birth, when placental detachment causes a rupture of the uterus, for example. Although blood transfusions during labour are relatively rare, each instance typically requires several units of red blood cell components.

Treatment of injuries accounts for approximately 12% of total blood component usage

In the population past middle age, clearly more blood components are used for men than women. Among men, a greater number of operations are required for the treatment of e.g. cardiovascular diseases and disorders of the digestive system. However, the proportion of women among over 80-year-olds in need of blood components is greater, since the overall proportion of women is growing among the older population.

Diagnoses most commonly associated with blood transfusions include malignant tumours of the blood, cardiovascular diseases and disorders of the digestive system. The treatment of injuries accounts for approximately 12% of total blood components used. Hospitals must always have an adequate reserve of blood components in case of emergencies, although the vast majority of blood components are used in scheduled operations.

Of all surgical operations, the treatment of cardiac blood vessels and vessels of the thoracic cavity, together with operations on the musculoskeletal and digestive system, require the largest amount of transfusions, particularly red cell transfusions. Through the development of surgical methods, the amount of red cell components needed in hip replacement operations, for example, has been significantly reduced.

Source: VOK Database, blood component usage 2002-2008 (includes information on approximately 70% of all blood transfusions in Finland)

What is the VOK Database?

The VOK Programme, focusing on the optimal use of blood, is a joint project of Finnish hospitals and the FRCBS. Its objective is to implement a nationwide blood component usage data system that doctors and nurses can access in order to obtain information on their hospital’s use of blood components. Experts meet to compare and develop hospitals’ transfusion practices. Information is collected to improve the quality of patient care.

Information on blood transfusions and patients who have received blood is collected from hospitals' electronic data logging systems. Additionally, the VOK Database includes patient information on diagnoses, operations and laboratory test results.

Approximately 70% of all blood transfusions taking place in hospitals are included in the VOK Database.