Makar, Robert S.

AbstractBackgroundGeographic information system (GIS) technology is widely used in public health to track disease patterns, though its application in transfusion medicine is limited. We report the use of GIS software by a hospital‐based blood donor program to examine patterns of blood drive activity.Study Design and MethodsWe performed a 3‐year retrospective study examining our donor program's mobile drives. Esri ArcGIS Pro™ software and ArcGIS Online™ were used to create vector and choropleth maps reflecting activity by town.ResultsSixteen thousand nine mobile whole blood donations were identified in 2021–2023. Four hundred and fifty‐five mobile blood drives were hosted at 189 unique locations. Seventeen towns within or intersecting a 15‐mile radius of our donation center had never been visited by our bloodmobile during the study period, with adult population sizes ranging from approximately 3000 to 53,000 representing donation opportunities. Untapped blood mobile opportunities were also identified in 33 Massachusetts towns (>700,000 adults) with nearby healthcare facilities in our hospital network.DiscussionGIS‐generated maps serve as an effective tool to identify previously successful blood donation locations and locations not yet visited by our donor program. Blood collection centers may benefit from future application of ArcGIS analysis tools to identify optimal locations for future mobile blood drives.

AbstractBackgroundImmune thrombotic thrombocytopenic purpura (iTTP) is a hematologic disorder characterized by severe acquired deficiency in ADAMTS13, resulting in thrombotic microangiopathy and death if untreated. Plasma exchange (PLEX) is the backbone of iTTP management and has improved survival in this disorder. Guidelines suggest initiation of PLEX within 4–8 h of presentation; however, there is little evidence to guide the precise timing of PLEX, and barriers exist to its timely deployment.Study design and methodsWe examined determinants of time between symptom onset to PLEX initiation (S2P) and hospital presentation to PLEX initiation (door to PLEX, D2P) in a large iTTP research cohort at an academic medical center.ResultsIn 225 cases occurring in 143 unique patients, the median (IQR) S2P time was 4.28 (1.92–7.47) days. In linear mixed effects regression analysis, increased S2P was associated with greater distance from a participating apheresis center (p = .01) and higher presenting platelet count (p = .046), while relapse presentation was associated with shorter S2P (p = .036). The median (IQR) D2P time was 8.4 (5.03–15.63) h. Longer D2P time was associated with a higher presenting platelet count (p = .002) and trended towards association with male sex (p = .057). Increased S2P and D2P times were not associated with hospital length of stay, mortality, or the composite of mortality and ICU stay.ConclusionOur data show that different factors contribute to the interval between symptom onset and presentation versus the time between presentation and initiation of therapy in iTTP.