台灣紅血球血品品輸用概況

Overview of Red Blood Cell Transfusion in Taiwan

為了解紅血球輸用需求走向，並提供制定病人用血管理（patient blood management）相關政策之方向，本研究使用台灣全民健康保險申報資料，分析2015年的紅血球輸血概況及近十年之變化情形。2015年總紅血球輸血量為2.149，868單位，40歲以下病人輸用量僅佔11.5%，65歲以上則佔53.4%。以使用科別來看，內科系及外科系各佔52.9%及32.4%，急診醫學科也佔了9.2%。比起2005年，外科系的紅血球總輸血量減少50，040單位，而內科系增加24.085單位，急診醫學科更是增加了111，860單位。以疾病類別來看，前五名依序為腫瘤（17.6%）、消化疾病（15.1%）、呼吸疾病（11.4%）、損傷及中毒（10.5%）與循環疾病（10.5%），與2005年相比，腫瘤增加32，654單位，消化疾病與損傷及中毒各減少了46，998與28，885單位。本研究提供現今紅血球的輸血概況及初步了解其變化情形，然而，未來仍需進一步探討特定科別或疾病的輸血量改變原因為何。 To evaluate the clinical need of red blood cell (RBC) and provide the references to patient blood management, we analyzed RBC utilization from 2005 to 2015 using transfusion data retrieved from the National Health Insurance claimed database. A total of 2,149,868 units of RBC was used in 2015 in Taiwan. 53% of RBC was transfused to patients aged more than 65 years, while only 11.5% transfused to patients aged under 40 years. Most of RBC were transfused at division of internal medicine (52.9%), then followed by division of surgery (32.4%) and department of emergency (9.2%). A decrease of RBC transfusion by 50,040 units at division of surgery was observed during 2005-2015. However, RBC transfusion quantity was increased by 24,085 and 111,860 units at division of internal medicine and department of emergency, respectively. Top five disease categories for which RBC transfusion was utilized were neoplastic diseases (17.6%), diseases of the digestive system (15.1%), diseases of the respiratory system (11.4%), injury and poisoning (10.5%), and diseases of the circulatory system (10.5%). Among these five disease categories, a decrease of RBC transfusion by 46,998, 20,354, and 28,885 units in diseases of the digestive system, diseases of the respiratory system, and injury and poisoning were observed during 2005-2015, respectively; while an increase of RBC transfusion by 32,654 units for patients with neoplasms was observed. We provide the overview of RBC transfusion in Taiwan and reveal its change in recent ten years. It is worthwhile to further clarify the reasons of changing RBC use in specific group of patients for formulating the policy of patient blood management.