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 blood transfusion that have a hemoglobin or hematocrit value documented prior to transfusion.
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.
Provider(s) who administered blood product
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, 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.
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.