Single‐unit transfusions and hemoglobin trigger: relative impact on red cell utilization

BACKGROUND Patient blood management (PBM) programs can reduce unnecessary transfusions, but the optimal methods used to achieve this effect are unclear. We tested the hypothesis that encouraging single‐unit red blood cell (RBC) transfusions in stable patients would have a greater impact on blood use than compliance with a specific hemoglobin (Hb) transfusion trigger alone. STUDY DESIGN AND METHODS We analyzed blood utilization data at three community hospitals without previous PBM efforts before and after implementing a PBM program. Data were analyzed at monthly intervals to determine the relative impact of a “Why give 2 when 1 will do?” campaign promoting single‐unit RBC transfusions and simultaneous efforts to promote evidence‐based Hb triggers of 7 or 8 g/dL. Univariate and multivariate analyses were used to identify independent effects of these two interventions on overall RBC utilization. RESULTS Univariate analysis revealed that both the increase in single‐unit transfusions (from 38.0% to 70.9%; p