An evaluation of the clinical impacts of 7‐day platelets
Bibliographic record
Abstract
Abstract Background In August 2017, Canadian Blood Services extended the shelf‐life of platelet concentrates from 5 to 7 days. The clinical impacts of this policy change remain unclear. Study Design and Methods We used a before‐after retrospective design of platelet‐transfused adult inpatients in Hamilton, ON, Canada. Data were captured for 18 months before (Period 1: February 2016–July 2017) and 18 months after (Period 2: September 2017–February 2019) 7‐day platelet implementation. Primary outcome was absolute platelet count increment (ACI) in univariate and multivariate analyses adjusted for confounders. Data were obtained from our institution's transfusion database, Ontario's Transfusion Transmitted Injuries Surveillance System, and the blood supplier. Results Overall, 1360 patients with single dose platelet transfusions were included in Period 1 and 1211 patients in Period 2. Median age at admission was 66 years, and approximately 40% of patients underwent cardiac surgery. Using a non‐inferiority margin of −10 × 109/L, platelets transfused during the 7‐day storage period were non‐inferior to those transfused in the 5‐day storage period [mean count difference − 4.63 × 109/L (95% CI −7.40 to −1.87, p = 0.0001)]. However, platelet ACIs following transfusion consistently trended lower in the 7‐day group for all patients and subgroups. No differences in secondary clinical outcomes were observed. Platelet expiry reduced from 8.1 to 6.3% (p < 0.0001). Conclusion Platelet transfusions following 7‐day storage policy were non‐inferior to transfusions in the 5‐day policy period, although reduced ACIs were observed. There were no increases in adverse clinical outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".