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Patient Blood Management

(P-PB-7) Non-White/Non-Caucasian Racial-Ethnic Patients Are Transfused RBCs at Lower Mean Pre-Transfusion Hemoglobin Levels Than White/Caucasian Patients

Sunday, October 26, 2025
12:00 PM - 1:00 PM  PT

    Presenting Author(s)

  • Jessica L. Jacobson, MD

    Laboratory Director and Chief of Pathology
    NYC H+H/Bellevue & NYU Grossman School of Medicine
    New York, New York, United States

Background/Case Studies: Recent studies suggest that Black patients are transfused less often and at lower hemoglobin thresholds than White patients. As a public hospital system which cares for a diverse patient population, we asked whether similar disparities are observable within our system.

Study

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

Results/Findings: 41,884 RBC units were transfused. 39,756 had a documented pre-Tx Hb with a mean of 7.342 g/dL. Asian patients were transfused 2711 RBCs with a mean pre-Tx Hb of 7.258 g/dL, African/African-American (A/AA) patients were transfused 3565 RBCs with a mean pre-Tx Hb of 7.306 g/dL, Hispanic patients were transfused 12,114 RBCs with a mean pre-Tx Hb of 7.325 g/dL, and White/Caucasian patients were transfused 17,223 RBCs with a mean pre-Tx Hb of 7.362 g/dL. Asian (p-value=5.8X10-8) and A/AA (p-value=0.037) patients were transfused at statistically significantly lower mean pre-Tx Hb levels than self-identified White/Caucasian patients. Mean pre-Tx Hb levels between all male and all female patients did not differ (p-value=0.059). Asian females were transfused at the lowest mean pre-Tx Hb of 7.007 g/dL. White Caucasian males had the highest mean pre-Tx Hb of 7.567 g/dL. A/AA females were transfused at higher pre-Tx Hb levels than A/AA males (p-value=0.002). Hispanic females (p-value=0.0001) and males (p-value=2.2X10-5) and Asian females (p-value=0.001) and males (p-value=8.2X10-5) were transfused at statistically significantly lower mean pre-Tx Hb levels than White/Caucasian females and males. A/AA (p-value=8.9X10-12) and Asian (p-value=8.2X10-5) male patients were transfused at statistically significantly lower mean pre-Tx Hb levels than White/Caucasian males.

Conclusions: Within our system despite standardized transfusion triggers, White/Caucasian male patients were far more likely to be transfused RBCs than other patients and had the highest mean pre-Tx Hb of 7.567 g/dL. Asian female patients were the least likely to be transfused and had the lowest mean pre-Tx Hb level of 7.007 g/dL.