Long-term survival in transfusion recipients in Sweden, 1993

BACKGROUND: Survival and characteristics of transfusion recipients have not been studied enough, although they represent key measures in cost-effectiveness analyses of various donor screening procedures. STUDY DESIGN AND METHODS: Hospital and blood bank records were collected on all patients in Orebro County, Sweden, from March through May 1993 (1111 transfusion episodes) and a random sample from Stockholm County during April 1993 (793 transfusion episodes). All patients were then matched with the national register of deaths in Sweden during a follow-up period of 40 months. RESULTS: The median patient age was 71 years and the median transfusion total was 2 units. Only 35 percent of the patients were under the age of 65, 9 percent under 40, and 1.6 percent under 1 year. About half (56%) were women. Among the Orebro patients, 47 percent were surgical and 29 percent internal medicine patients. Of 1720 patients whose survival could be investigated, 66 percent were alive after 1 year and 51 percent after 40 months. The survival rates were rather similar in patients receiving RBCs and plasma but lower in those receiving platelets. CONCLUSION: The survival of patients transfused in Sweden in 1993 differered significantly from estimations based on studies from the 1980s. This difference has major implications for the estimations of cost-effectiveness of blood donor screening for infectious agents.