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Predicting changes in hemoglobin S after simple transfusion using complete blood counts
Journal article   Open access   Peer reviewed

Predicting changes in hemoglobin S after simple transfusion using complete blood counts

Gagan Mathur, Patrick Ten Eyck and C Michael Knudson
Transfusion (Philadelphia, Pa.), Vol.58(1), pp.138-144
01/2018
DOI: 10.1111/trf.14371
PMCID: PMC6209099
PMID: 29023896
url
https://doi.org/10.1111/trf.14371View
Published (Version of record) Open Access

Abstract

Hemoglobin S percentages are used in the management of patients who have sickle cell disease. However, hemoglobin S measurements often are not routinely or rapidly performed. Rapid and accurate methods to estimate hemoglobin S levels after simple transfusion may improve the care of patients with sickle cell disease. A comprehensive review of the electronic medical record identified 24 stable patients with sickle cell disease who received simple red blood cell transfusions and had hemoglobin S measurements before and after the transfusion that were less than 72 hours apart. Examination of these patients identified 62 separate transfusions that met our criteria. Three simple equations that utilized complete blood count values and readily available information from the medical record were used to predict the post-transfusion hemoglobin S level after transfusion (Equation 1: predicted post-transfusion hemoglobin = pre-transfusion hemoglobin S × [pre-transfusion hemoglobin/post-transfusion hemoglobin]; Equation 2: predicted post-transfusion hemoglobin S = pre-transfusion hemoglobin S × [pre-transfusion hematocrit/post-transfusion hematocrit]; and Equation 3: predicted post-transfusion hemoglobin S = pre-transfusion hemoglobin S × total pre-transfusion hemoglobin/[total pre-transfusion hemoglobin + (red blood cell volume × 20)]). The predicted hemoglobin S values for all three equations showed a highly significant correlation with the measured post-hemoglobin S value. The coefficient of determination (R ) for Equations 1, 2, and 3 was 0.95, 0.92, and 0.97, respectively. Predicting the post-transfusion hemoglobin S value using estimates of the patient's total hemoglobin and the transfused hemoglobin (Equation 3) was the most precise. Reductions in hemoglobin S values in patients with sickle cell disease who receive simple red blood cell transfusions can be reliably predicted using complete blood cell measurements and simple arithmetic equations.
Adolescent Adult Algorithms Anemia, Sickle Cell - blood Anemia, Sickle Cell - therapy Blood Cell Count Blood Transfusion Blood Volume Child Child, Preschool Electronic Health Records Female Hematocrit Hemoglobin SC Disease - blood Hemoglobin SC Disease - therapy Hemoglobin, Sickle - analysis Hemoglobinometry - instrumentation Humans Infant Male Middle Aged Retrospective Studies Time Factors Young Adult

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