Global Journal of Transfusion Medicine (Jan 2016)

Blood utilization practices in elective surgical patients in a Tertiary Care Hospital of Uttarakhand

  • Akshat Kuchhal,
  • Gita Negi,
  • Dushyant Singh Gaur,
  • Meena Harsh

DOI
https://doi.org/10.4103/2455-8893.189843
Journal volume & issue
Vol. 1, no. 2
pp. 51 – 56

Abstract

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Background: Ordering of blood is a common practice in elective surgical procedures. Unnecessary blood orders need to be waived to reduce both workload and financial expenditure. We need to optimize the quantity of blood being cross-matched, by assigning each surgical procedure, a tariff of transfusion. To this effect, the maximum surgical blood ordering schedule(MSBOS) is one such approach. The study was performed with the aim of evaluating whether preoperative blood cross-matching in our hospital is well adjusted to the actual intraoperative blood usage. Materials and Methods: A hospital-based retrospective cross-sectional study was conducted in those patients who underwent elective surgeries in Himalayan Institute Hospital Trust hospital over a period of 1year. Blood requisitions and transfusions were compiled and reviewed. The number of units requested, cross-matched and transfused along with number of patients cross-matched and transfused were collected. The blood bank requisition forms, databases, old surgical records, and discharge sheets were reviewed. Following indices were calculated: (i) Cross-match to transfusion ratio(C/T), (ii) Transfusion probability(T%), (iii) Transfusion index(TI), (iv) MSBOS. Results: Atotal of 2370patients underwent 214 different elective procedures are included in this study. Totally, 1184 red blood cells units were cross-matched, and only 625 units(52.7%) were transfused to 331patients. The overall C/T ratio calculated was 1.8, TI was 0.5 and T% was 61.7%. All these figures were found to be within the desirable range. Based on these indices, MSBOS was formulated for each procedure. Conclusion: The study indicated an adequate overall ratio of C/T, T%, and TI except a few surgeries that showed transfusion indices beyond accepted levels. Developing a blood ordering policy(MSBOS), to guide the clinicians regarding blood usage can decrease over ordering of blood thereby reducing unnecessary compatibility testing, returning of unused blood, and wastage due to outdating.

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