Icahn School of Medicine at Mount Sinai Great Neck, New York, United States
Background/Case Studies: Management of short-lived Single Donor Platelet (SDP) inventory is challenging. Understanding modifiers of utilization helps optimize managing strategies.
Study
Design/Methods: For the year 2024, monthly SDP transfusions, pre-transfusion platelet counts, and indication were extracted from electronic medical records, and compared for patients with head injury versus all others. Monthly Thrombo-elastography (TEG 6S) abnormal platelet function tests (CRT< 51, ADP< 45, AA< 51) and all TEG tests were retrieved from the TEG Manager Platform, and percent of tests resulted as abnormal platelet function was calculated.
Results/Findings: When looking at SDP utilization at this Level 1 Trauma Center during 2024 (Figure A), 80% of SDP were transfused and 20% were discarded. Most transfused SDP (74%) went to patients without head injury with a mean platelet count of 60K, while 26% of SDP went to patients with head injury with higher platelet counts (mean 124K). Percent abnormal platelet function on TEG correlated better with SDP transfusions to patients with head injury than with those without head injury. SDP transfusions to patients without head injury correlated inversely with discards. Conclusions: Discards are more likely related to expiring platelets when number of SDP transfusions to patients without head injury is lower. It appears that TEG results are considered for SDP transfusions in patients with head injury but are not considered for SDP transfusion in patients without head injury. SDP transfusions to patients without head injury is the primary determinant of and inversely correlated with SDP discards.
