RLA Physician Letter

Vol 5 Issue 2
March 2001

Trends in Blood Collection and Utilization

Blood collections and utilization increased dramatically in Kansas City and throughout the United States during the past several years. Last year Community Blood Center (CBC) distributed 127,439 red cell units compared to 113,670 in 1999.

Nationally, blood collection and utilization declined between the early and mid 1990's and then increased slightly between 1994, when 11.1 million units were transfused, and 1997, when 11.5 million units were transfused. By 1999 (the latest year for which information is available), 12.4 million units were transfused, an increase of 7.8% over 1997. At hospitals associated with the Regional Laboratory Alliance, CBC records show blood utilization increased 6% between 2000 and 1999. These hospitals had annual increases of 5% each year since 1997. Of note, usage patterns at selected Kansas City metropolitan hospitals show wide differences. While these data have not been analyzed for acuity of illness, previously published information indicates transfusion utilization patterns reflect specific hospital practices that have been attributed to training or hierarchical pressures that become ingrained.

In the face of recent increases in blood utilization, blood banking organizations are concerned about a declining donor base. In a recent general survey, the proportion of respondents answering affirmatively to a question about whether they had ever donated blood was lower than that observed in any study conducted previously. This has been attributed to differences in population demographics. In general, baby boomers (1946-64) and pre-boomers (born prior to 1946) roll up their sleeves while those considered Generation X (born 1961-1980) do so reluctantly. In 1988 in Kansas City, 32% of the blood was donated by those 24-35 years of age (baby boomers) compared to only 19% of those in the same age bracket (Generation X'ers) in 1999. Greater emphasis on educating these younger donors about the importance of donating blood is needed as the population ages and blood utilization increases.

In an effort to ensure blood availability for those needing it, an article in next month's newsletter will address physiologic changes associated with low hemoglobin levels and current recommendations about threshold levels of ordering transfusions.