Optimizing Platelet Transfusion Practices: A Comprehensive Analysis of Adherence to Guidelines in a Tertiary Care Hospital

Abstract

Objective: To evaluate adherence of platelet transfusion practices to British Society for Haematology (BSH) guidelines – 2024 and identify patterns of non-compliance across clinical settings.
Study Design: A descriptive cross-sectional study.
Place and Duration of Study: Department of Haematology and Blood Bank, Fauji Foundation Hospital, Rawalpindi, from July 01, 2025 to December 31, 2025.
Materials and Methods: A total of 260 patients who received platelet transfusions during the study period were included. Demographic details, clinical diagnoses, indications for transfusion, and requesting departments were recorded. The appropriateness of platelet transfusion practices was assessed in accordance with the 2024 BSH platelet transfusion guidelines. Data were analyzed using SPSS v29. Guideline adherence was classified as adherent or non-adherent, and associations between diagnosis and adherence were assessed
using the Chi-square test.
Results: Adults constituted 56.2% of study population, whereas paediatric patients accounted for 43.8%. Females constituted 66.5% of the study population. Most platelet transfusions were administered in the NICU (18.1%), followed by oncology units (15.4%), ICU (14.2%), Medical wards (14.2%), paediatric wards (14.2%) and others (23.9%). Overall, 161 platelet transfusions (61.9%) were found to be compliant with the recommended transfusion guidelines, whereas 99 transfusions (38.1%) were identified as non-compliant.
Conclusion: Despite reasonable overall compliance, a substantial proportion of platelet transfusions were inappropriate, particularly in non-haematology settings. These findings highlight the need to strengthen transfusion management, to improve guideline adherence, enhance patient safety and optimize platelet utilization.