This measure is calculated based on data extracted from the electronic medical record combined with administrative data sources such as professional fee and discharge diagnoses data. This measure is explicitly not based on provider self-attestation.
Percentage of cases with a post transfusion hemoglobin or hematocrit value greater than or equal to 10 g/dL or 30%.
90 minutes before the last intraoperative transfusion to 18 hours after Anesthesia End
Any patient that receives a red blood cell transfusion. Transfusion is defined as packed red blood cells or whole blood. See MPOG Concept IDs below for complete list.
Individual who administered the transfusion
Blood Product MPOG Concept IDs |
Point of Care Testing MPOG Concept IDs |
Formal Lab MPOG Concept IDs |
EBL MPOG Concept ID |
||||
10489 |
Packed Red Blood Cells- Autologous |
3415 |
POC-Blood gas-Hct measured |
5005 |
Formal lab- Hemoglobin |
10499 |
EBL |
10490 |
Packed Red Blood Cells- Homologous |
3435 |
POC- hematocrit spun |
5006 |
Formal lab- Hematocrit |
|
|
10492 |
Whole Blood- Homologous |
3440 |
POC- Coulter counter- Hemoglobin |
5038 |
Formal lab- Blood gas- Hct measured |
|
|
10616 |
Packed Red Blood Cells- Unknown Type |
3450 |
POC- Coulter counter- Hematocrit |
5080 |
Formal lab- Blood gas- Hemoglobin |
||
10617 |
Whole Blood- Unknown Type |
5081 |
POC- Blood gas- Hemoglobin |
||||
10618 |
Categorized Note- Blood Products |
The American Association of Blood Banks (AABB) recommends a transfusion threshold of hemoglobin concentration less than or equal to 8 g/dL or when patient is symptomatic (chest pain, orthostatic hypotension, tachycardia unresponsive to fluid resuscitation, or congestive heart failure).1,2 Furthermore, blood transfusions in non-cardiac surgery have been associated with increased risk of 30-day mortality and morbidity.3,4
Although the literature is not conclusive on the exact hemoglobin concentration that requires transfusion, the evidence is clear that use of fewer RBC transfusions reduces cost and risk for adverse effects of transfusion, and that transfusion to hemoglobin value greater than 10 g/dL or hematocrit greater than 30 is almost always not indicated.5 TRAN 02 is an outcome measure examining the number of patients who may have received more blood than necessary.
Not applicable
1. Carson JL, Grossman BJ, Kleinman S, et al. Red blood cell transfusion: a clinical practice guideline from the AABB*. Annals of internal medicine. 2012;157(1):49-58.
2. Carson JL, Guyatt G, Heddle NM, et al. Clinical Practice Guidelines From the AABB: Red Blood Cell Transfusion Thresholds and Storage. Jama. 2016;316(19):2025-2035.
3. Glance LG, Dick AW, Mukamel DB, et al. Association between intraoperative blood transfusion and mortality and morbidity in patients undergoing noncardiac surgery. Anesthesiology. 2011;114(2):283-292.
4. Napolitano LM, Kurek S, Luchette FA, et al. Clinical practice guideline: red blood cell transfusion in adult trauma and critical care. The Journal of trauma. 2009;67(6):1439-1442.
5. Practice guidelines for perioperative blood management: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Management*. Anesthesiology. 2015;122(2):241-275.