Evaluation of appropriate usage of fresh frozen plasma: Results of a regional audit in Iran

Background: Fresh frozen plasma (FFP) is a major source of coagulation factor replacement therapy for patients with clotting factor deficiency. Although FFP is readily available for use in clinical practice its administration isn't without risk. Studies on the use of FFP reveal that it is often overused or inappropriately used. We undertook an audit to assess the appropriateness of FFP transfusion in Gorgan's hospitals. Methods: This was a retrospective, audit done at 5 hospitals in Gorgan city regarding the use of 1592 units of FFP issued to 346 patients from March 2006 to March 2007. The appropriateness of FFP transfusion was analyzed according to British Council for Standardization in Hematology (BCSH) Guidelines 2004. Results: In this audit we identified a high rate of inappropriate FFP usage (53% of transfusion episodes). Most 'Inappropriate' FFP usage occured when there was active bleeding, with normal (or unmeasured) coagulation tests (30% of transfusion episodes). In only 66% of FFP-transfused patients were coagulation variable measured at any point in the hospital episode. Conclusion: Inappropriate usage of FFP is often seen in medical facility and the right solution is needed to curb the misuse of this component. Regular utilization audit can identify correctable errors in transfusion practices. Formal education programs and existing information on FFP use should be directed to professionals ordering FFP. (C) 2009 Elsevier Ltd. All rights reserved.