Release Notes:
Measure Information Form
Version 2010A1
Measure Information Form
Measure Set: Blood Management(BM)
Set Measure ID: BM-04a
Performance Measure Name: Platelet Transfusion Indication
Description: The total number of platelet events with pre-transfusion platelet testing AND clinical indication documentation from a sample of patients who received platelets.
Rationale: Platelets are transfused to treat or prevent bleeding associated with thrombocytopenia and/or platelet dysfunction. Platelets given therapeutically should help stop the bleeding, and if given prophylactically, post transfusion platelet counts should be obtained to monitor the response to determine the effectiveness of the transfusion. Repeated platelet transfusions can cause alloimmunization and cause platelet refractoriness to future transfusions. Multiple infectious risks are associated with platelet transfusions so patients should only be exposed to the least amount needed. There is consensus that the platelet count should be maintained above 50,000/μL in patients with acute bleeding with a higher target for patients with multiple trauma or central nervous system injury.
Type of Measure: Process
Improvement Noted As: Increase in the rate
Numerator Statement: Number of platelet transfusion events with pre-transfusion platelet testing AND clinical indication documented
Included Populations: Not applicable
Excluded Populations: None
Data Elements:
Denominator Statement: Number of platelet events evaluated
Included Populations:
- Discharges with an ICD-9-CM Principal or Other Procedure Codes for transfusion as defined in Appendix A, Table 9.5.
- The first three platelet events per patient after hospital arrival
Excluded Populations:
- Patients less than 4 months of age
- With an ICD-9-CM Principal or Other Diagnosis Code for Neoplasms or Chemotherapy as defined in Appendix A, Table 9.7 or 9.8.
Data Elements:
Continuous Variable Statement:
Included Populations:
Excluded Populations:
Data Elements:
Risk Adjustment: No.
Data Collection Approach: Retrospective data sources for required data elements include administrative data and medical records.
Data Accuracy: Variation may exist in the assignment of ICD-9-CM codes; therefore, coding practices may require evaluation to ensure consistency. If ICD-9-CM codes are not present, alternative methods of identifying patients who received blood transfusions may be required.
Measure Analysis Suggestions: Data from this measure may be used to evaluate the utilization of platelets in an organization.
Sampling: Yes. For additional information see the Population and Sampling Specifications.
Data Reported As: Aggregate rate generated from count data reported as a proportion.
Selected References:
- Garrioch M, Sandbach J, Pirie E, Morrison A, Todd A, Green R. Reducing red cell transfusion by audit, education and a new guideline in a large teaching hospital. Transfusion Med. 2004;14:25-31.
- Petrides M. Red cell transfusion “trigger”: A review. Southern Med J. 2003; 96:664-667.
- Roback JD, ed. Technical manual. 16th ed, Bethseda, MD: AABB, 2008.
- BR J Haematol 1998, 101:609 - 617.
Measure Algorithm:
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