(P-PB-9) Patients Whose Preferred Language for Health Information Is Not English Experience Disparate RBC and SDP Transfusion Administration Practices

Background/Case Studies: As a safety net hospital system served by patients from all over the world, we offer our patient 59 languages from which to select from as their preferred language to receive health information. Each patient must have their preferred language documented in the demographic section of the electronic medical record. Transfusion consent forms are available in English, Bangla/Bengali, French, Haitian Creole, Russian, Spanish, simplified Chinese, traditional Chinese, Albanian, Arabic, Hindi, Korean, Polish, and Urdu. Interpretation services are available 24X7 via qualified bilingual in-person face-to-face, over-the-phone, video remote, and translation of written materials. We sought to assess whether our patients whose preferred language is not English experience disparities in RBC transfusion practice.

Study

Design/Methods: We performed a retrospective analysis of all RBC and SDPs transfusions from 11 acute care hospitals performed in 2024. Patients were sorted by self-identified preferred language. The pre-transfusion hemoglobin (pre-Tx Hb) and platelet count (pre-Tx Plt Ct) levels tied to the transfusions were compared. Results were assessed using the Student’s T-test.

Results/Findings: 41,884 RBCs and 5804 SDPs were transfused. 39,756 had a documented pre-Tx Hb with a mean of 7.342 g/dL and 5651 with a pre-Tx Plt Ct mean of 66.826X10⁹/L. 29,066 RBCs (69.4%) and 3469 SDPs (59.8%) were transfused to patients who selected English, and 12,818 (30.6%) RBCs and 2238 (38.6%) were transfused to patients who selected one of the 58 other language (non-English) options. The mean pre-Tx Hb of the English preferred was 7.361 g/dL and 7.297 g/dL for the non-English preferred. Patients designating English as their preferred language were statistically significantly more likely to be transfused RBCs (p-value < 0.006) than non-English preferred. English preferred males were transfused RBCs at a higher mean pre-Tx Hb value of 7.548 g/dL than English preferred females at 7.145 g/dL (p-value < 0.000005). Non-English preferred males and females were transfused at similar pre-Tx Hb levels (7.332 g/dL vs 7.259 g/dL) (p-value=0.059). The mean pre-Tx Plt Ct of the English preferred was 68.669X10⁹/L and 64.037X10⁹/L for the non-English preferred (p-value=0.034). English preferred females were transfused SDPs at statistically significantly lower mean pre-Tx Plt Ct of 62.034X10⁹/L than English preferred males at 72.157 X10⁹/L (p-value < 0.0005). Non-English preferred males and females were transfused at similar mean pre-Tx Plt Ct at 63.76X10⁶/L and 64.727X10⁶/L (p-value=0.79).

Conclusions: Non-English language preferred patients were transfused SDPs at statistically significantly lower pre-Tx Hb and pre-Tx Plt counts than English language preferred patients. English preferred language males were transfused both RBCs and SDPs at statistically significantly higher pre-Tx Hb and Plt counts than all others.