Background: Annual transfusion rates in many European countries range between 25 and 35 red blood cell concentrates (RBCs)/1,000 population.It is unclear why transfusion rates in Germany are considerably higher (approx. 50–55 RBCs/1,000 population). Methods: We assessed the characteristics of transfusion recipients at all hospitals of the German federal state Mecklenburg-Western Pomerania during a 10-year longitudinal study. Results: Although 75% of patients received ≤4 RBCs/patient in 2015 (1 RBC: 11.3%; 2 RBCs: 42.6%; 3 RBCs: 6.3%; 4 RBCs: 15.0%), the mean transfusion index was 4.6 RBCs due to a minority of patients with a high transfusion demand. Two thirds of all RBCs were transfused to only 25% of RBC recipients. Consistently, male patients received a higher number of RBCs (2005: 54.2%; 2015: 56.8%) and had a higher mean transfusion index than female patients (mean 5.1 ± 7.2; median 2; inter-quartile range [IQR] 2–4 vs. mean 4.0 ± 5.8; median 2; IQR 2–4). The absolute transfusion demand decreased between 2005 and 2015 by 13.5% due to a composite of active reduction (clinical practice change) and population decline in the 65- to 75-year age group (lower birth rate cohort 1940–1950); however, with major differences between hospitals (range from –61.0 to +41.4%). Conclusion: Transfusion demand in a population could largely be driven by patients with high transfusion demand. Different treatment practices in this group of patients probably add to the major differences in transfusion demand per 1,000 individuals between countries. The available data cannot prove this hypothesis. Implementation of a diagnosis-related group-based monitoring system is urgently needed to allow informative monitoring on the population level and meaningful comparisons between transfusion practices.

中文翻译：

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德国联邦州红细胞浓缩物接受者的特征


背景：许多欧洲国家的年输血率在 25 至 35 个红细胞浓缩物 (RBC)/1,000 人之间。目前尚不清楚为什么德国的输血率要高得多（大约 50-55 个 RBC/1,000 人）。方法：我们在一项为期 10 年的纵向研究中评估了德国联邦州梅克伦堡-前波美拉尼亚州所有医院的输血接受者的特征。结果：尽管 2015 年，75% 的患者接受了 ≤4 个红细胞/患者（1 个红细胞：11.3%；2 个红细胞：42.6%；3 个红细胞：6.3%；4 个红细胞：15.0%），但平均输血指数为 4.6 个红细胞，因为少数有较高输血需求的患者。三分之二的红细胞被输注给了仅 25% 的红细胞接受者。一致地，男性患者接受的红细胞数量较多（2005 年：54.2%；2015 年：56.8%），且平均输血指数高于女性患者（平均值 5.1 ± 7.2；中位数 2；四分位数范围 [IQR] 2-4）与平均值 4.0 ± 5.8；中位数 IQR 2-4）。由于主动减少（临床实践的变化）和65至75岁年龄组人口下降（1940-1950年较低出生率队列）的综合作用，2005年至2015年间绝对输血需求下降了13.5%；然而，不同医院之间存在重大差异（范围从 –61.0 到 +41.4%）。结论：人群的输血需求很大程度上是由高输血需求的患者驱动的。这组患者的不同治疗方法可能会增加各国之间每 1,000 人输血需求的主要差异。现有数据无法证明这一假设。 迫切需要实施与诊断相关的基于群体的监测系统，以便对人群进行信息监测并在输血实践之间进行有意义的比较。