Percentage of patients with a blood transfusion that have a hemoglobin or hematocrit value documented prior to transfusion.
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, tachcardia 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
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 for hemoglobin values greater than 10 g/dL is usually not indicated.
TRAN 01 is a process measure focused on measuring hemoglobin or hematocrit prior to transfusion. The rationale for this measure is that the decision to transfuse should include knowledge of the hemoglobin value before administration of blood. Because the literature is not absolutely conclusive on a specific hemoglobin threshold for transfusion, TRAN 01 does not include the actual hemoglobin value as part of the measure.
Up to 36 hours prior to the first transfusion during the case
All surgical patients receiving anesthetics who receive a transfusion of red blood cells.
*Cases where the ‘Measure End Time’ precedes ‘Measure Start Time’ will be excluded and marked 'invalid'
Not applicable
Provider(s) who administered blood product
Blood Products
Point of Care Testing
Formal Labs
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.
Measure Author |
Institution |
Nirav Shah, MD |
University of Michigan |
Kate Buehler, MS, RN |
University of Michigan |
Jaime Osborne, RN |
University of Michigan |
Jay Jeong |
University of Michigan |
Sachin Kheterpal, MD |
University of Michigan |
MPOG Quality Committee |
Date Reviewed | Reviewer | Institution | Summary | QC Vote |
---|---|---|---|---|
05/24/2021 |
Linda Lui, MD Masakatsu Nanamori, MD |
UCSF HFHS - Detroit |
Modify |
Date | Criteria | Revision |
---|---|---|
None |