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Release Notes:
Measure Information Form
Version 2010A1

Measure Information Form

Measure Set: Blood Management(BM)

Set Measure ID: BM-04b

Performance Measure Name: Prophylactic Platelet Transfusion Indication

Description: The total number of platelet transfusion events that had a pre-transfusion platelet count less than or equal to 10,000/μL OR clinical indication documentation from a sample of selected hematology patients that received platelets.

Rationale: Prophylactic platelet transfusion therapy is an essential part of supportive care in hematology and oncology. Platelets may be useful if given as prophylaxis to patients with rapidly decreasing or low platelet counts secondary to cancer, marrow aplasia or chemotherapy. A landmark study by Rebulla and associates in 1997 showed that patients transfused with a platelet trigger of 10 x 109/L had no more bleeding episodes than those who were transfused at a trigger of 20 x 109/L. Numerous studies and prospective randomized trials have since demonstrated that in the absence of fever and bleeding, a threshold of 10,000 platelets/μL was as safe as 20,000 platelets/μL to prevent mortality as well as major or severe bleeding events. The lower threshold also allows a significant reduction in platelet transfusions.

Type of Measure: Process

Improvement Noted As: Increase in the rate

Numerator Statement: Number of platelet transfusion events with pre-transfusion platelet count ≤ 10,000/μL OR 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 Diagnosis Code for Neoplasms or Chemotherapy as defined in Appendix A, Table 9.7 or 9.8 AND 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
  • Who had a surgical procedure using general or neuraxial anesthesia

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 could be used to evaluate the utilization of platelets in this high-use population. Tracking post-transfusion platelet count results could provide information about whether the transfusion was successful.

Sampling: Yes. For additional information see the Population and Sampling Specifications Section.

Data Reported As: Aggregate rate generated from count data reported as a proportion.

Selected References:

  • Blajchman MA. Landmark studies that have changed the practice of transfusion medicine. Transfusion. 2005;45:1523-1530.
  • Rebulla P, Finazzi G, Marangoni F, et al. The threshold for prophylactic platelet transfusion in adults with acute myeloid leukemia. N Engl J Med. 1997;337:1870-5.
  • Roback JD, ed. Technical manual. 16th ed, Bethseda, MD: AABB, 2008.

Measure Algorithm:

Attach file

Related Topics

Measure Information Form BM-04b
Specifications Manual for Joint Commission National Quality Core Measures (2010A1)
Discharges 04-01-10 (2Q10) through 09-30-10 (3Q10)