(P-PB-6) Non-White/Non-Caucasian Racial-Ethnic Patients Are Transfused Platelets at Lower Mean Pre-Transfusion Platelet Counts When Compared to White/Caucasian Patients

Background/Case Studies: Recent studies suggest that Black patients are transfused less often and at lower hemoglobin thresholds than White patients. No published data has looked at transfusion practices with respect to platelet transfusions and patient’s self-identified racial-ethnic group. As a public hospital system which cares for a diverse patient population, we asked whether disparities are occurring within our system.

Study

Design/Methods: We performed a retrospective analysis of all SDP transfusions performed at our 11 acute care hospitals in 2024. Patients were sorted by self-identified racial-ethnic group. The pre-transfusion platelet (pre-Tx Plt) count levels tied to the transfusions were compared. Results were assessed using the Student’s T-test.

Results/Findings: From 1/1/24 to 12/31/24, 5804 SDPs were transfused. 5651 had a documented pre-Tx Plt count with a mean of 66.78X10⁹/L. African/African-Americans (A/AA) were transfused 166 SDPs with a mean pre-Tx Plt count of 61.384X10⁹/L, Hispanics were transfused 2023 SDPs with a mean pre-Tx Plt count of 63.478X10⁹/L, Asians were transfused 423 SDPs with a mean pre-Tx Plt count of 70.161X10⁹/L, and White/Caucasians were transfused 1965 SDPs with a mean pre-Tx Plt count of 74.946X10⁹/L. A/AA (p-value < 0.000002) and Hispanic (p-value < 0.0002) patients were transfused at statistically significantly lower mean pre-Tx Plt count than White/Caucasian patients. A/AA (p-value < 0.000002) and Hispanic (p-value=0.039) patients were transfused at statistically significantly lower mean pre-Tx Plt counts than Asian patients. Although Asians had a lower mean pre-Tx Plt count at 70.161X10⁹/L than White/Caucasians at 74.946X10⁹/L, no statistical difference was observed between the pre-Tx Plt counts of Asian and White/Caucasian patients (p-value=0.83). A/AA males were transfused at the lowest mean pre-Tx Plt count of 43.932X10⁹/L and A/AA females were transfused at the highest mean pre-Tx Plt count of 106.152X10⁹/L.

Conclusions: Within our system despite standardized transfusion indications, African/African-American and Hispanic patients were transfused platelets at a statistically significantly lower mean pre-Tx platelet count than either White/Caucasian or Asian patients. At least with respect to platelet transfusions, self-identifying as Asian or White/Caucasian did not lead to disparate transfusion practice. Given the overall small number of SDP transfusions to evaluate in some of the categories after separating by both gender and racial-ethnic group, conclusions regarding differences in platelet transfusion practice cannot be made.