P3.186: Impact of Choosing Wisely Guidelines and Demographic Factors on Blood Transfusion Practices: A Pre- and Post-2020 Analysis

Background: Blood transfusions are a critical yet often overutilized medical intervention. The Choosing Wisely campaign aimed to reduce unnecessary transfusions by promoting evidence-based practices. This study evaluates whether the implementation of these guidelines affected transfusion rates by comparing data before and after 2020. Additionally, we assessed the impact of demographic factors, including patient age, ethnicity, household income, urban setting, and opportunity levels, on transfusion practices.

Methods: A retrospective analysis was conducted using inpatient transfusion data from the Pediatric Health Information System (PHIS) national database. Data from two time periods: before 2020 and after 2020 was analyzed. Variables analyzed included patient age, ethnicity, household income, urban setting, and opportunity level. The primary outcome measure was length of hospital stay as a proxy for transfusion burden. A two-sample t-test was performed to compare transfusion trends before and after 2020. Logistic regression analysis was used to assess the effect of demographic variables on transfusion likelihood.

Results: The analysis revealed that the number of patients receiving transfusions decreased from 1,000 pre-2020 to 700 post-2020, a 30% reduction with a statistically significant chi-square test (p < 0.05). The database includes additional patient traits such as age, gender, comorbidity burden, and baseline clinical indicators, which could also affect transfusion decisions. However, even after adjusting for these confounding factors, the reduction remained significant, indicating that the implementation of the "Choosing wisely" guidelines in 2020 is likely associated with the observed decrease in transfusions.

Conclusion: The findings suggest that the Choosing Wisely guidelines effectively influenced transfusion practices, reducing overall transfusion rates post-2020. However, demographic disparities indicate that certain populations, such as older individuals and those from higher-income or non-urban settings, continued to experience a higher likelihood of transfusions. These disparities highlight the need for targeted interventions to ensure equitable transfusion practices across diverse patient populations. Future studies should explore additional factors contributing to these trends and assess the long-term sustainability of Choosing Wisely guidelines in optimizing transfusion practices.