1Cardiac Anesthesia Research Center, Imam-Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2Cardiac Anesthesia Research Center, Imam-Reza Hospital,
Faculty of Medicine, Mashhad University of Medical
Sciences, Mashhad, Iran
Background: Reservation of blood leads to blood wastage if the blood is not transfused. Therefore, in some centers only blood type and screen are evaluated. In this study, the efficacy of a blood crossmatch-to-transfusion ratio was measured and then compared with the standard levels. Methods: This prospective study was conducted during one year in a university hospital. During this period, 398 patients for whom blood had been requested were studied. In these patients, at the first surgical type, the laboratory tests (hematocrit, hemoglobin, platelet count, and prothrombin time) and the number of preoperative crossmatched and intraoperative transfused blood units were recorded. Then the crossmatch-to-transfusion ratio, transfusion probability, transfusion index, and correlation between related factors, and the transfusion ratio were evaluated. Results: In this cross-sectional study, blood was requested for 398 patients. According to available blood unit deficiency, from 961 blood unit requisitions, only 456 units were crossmatched and 123 units were transfused. The crossmatch-to-transfusion ratio, transfusion probability, and transfusion index were 3.71 (7.81 if all requisitions were crossmatched), 16.83%, and 0.31, respectively. The most unfavorable indexes were observed in patients who had ear, nose, and throat surgeries (0 transfused from 19 crossmatched blood units) and obstetric and gynecologic surgery (crossmatch-to-transfusion ratio was 18.6). The best indexes were related to thoracic surgery and neurosurgery (crossmatch-to-transfusion ratio was 1.53 and 1.54, respectively). There were no significant correlations between hemoglobin, hematocrit, platelet count, and prothrombin time with the number of transfused blood units (P = 0.2, 0.14, 0.26, and 0.06, respectively). Conclusion: The data for the crossmatch-to-transfusion ratio, transfusion probability, and transfusion index were suboptimal at this center, especially for ear, nose, and throat and obstetric and gynecologic surgeries. Further multidimensional studies and determination of a new model for blood requests and to decrease blood wastage are needed.
Bhutia SG, Srinivasan K, Ananthakrishnan N, Jayanthi S, Ravishankar M. Blood utilization in elective surgery--requirements, ordering and transfusion practices. Natl Med J India. 1997; 10(4):164-8.
Chawla T, Kakepoto GN, Khan MA. An audit of blood cross-match ordering practices at the Aga Khan University Hospital: first step towards a Maximum Surgical Blood Ordering Schedule. J Pak Med Assoc. 2001; 51(7):251-4.
Vibhute M, Kamath SK, Shetty A. Blood utilisation in elective general surgery cases: requirements, ordering and transfusion practices. J Postgrad Med. 2000; 46(1):13-7.
Boral LI, Henry JB. The type and screen: a safe alternative and supplement in selected surgical procedures. Transfusion. 1977; 17(2):163-8.
Friedman BA, Oberman HA, Chadwick AR, Kingdon KI. The maximum surgical blood order schedule and surgical blood use in the United States. Transfusion. 1976; 16(4):380-7.
Mead JH, Anthony CD, Sattler M. Hemotherapy in elective surgery: an incidence report, review of the literature, and alternatives for guideline appraisal. Am J Clin Pathol. 1980; 74(2):223-7.
Olawumi HO, Bolaji BO. Blood utilization in elective surgical procedures in Ilorin. Trop J Health Sci. 2006; 13(1):15–7.
Friedman BA. An analysis of surgical blood use in United States hospitals with application to the maximum surgical blood order schedule. Transfusion. 1979; 19(3):268-78.
Hall TC, Pattenden C, Hollobone C, Pollard C, Dennison AR. Blood transfusion policies in elective general surgery: how to optimise cross-match-to-transfusion ratios. Transfus Med Hemother. 2013; 40(1):27-31.
Kozarzewska M, Mackowiak M, Steler J, Krefta M, Hasak L, Kardel-Reszkiewicz E. The analysis of surgical blood order protocol. Anestezjol Intens Ter. 2011; 43(2):71-3.
Belayneh T, Messele G, Abdissa Z, Tegene B. Blood requisition and utilization practice in surgical patients at university of Gondar hospital, Northwest Ethiopia. J Blood Transfus. 2013; 2013(10):1-5.
Ibrahim SZ, Mamdouh HM , Ramadan AM. Blood utilization for elective surgeries at main university hospital in Alexandria, Egypt. J Am Sci. 2011; 7(6):683–9.
Nikpoor AR, Daneshvar H, Sanei ME, Askari M. Assessment of requisition and consumption indices of blood in educational hospitals in Kerman city. Sci J Iran Blood Transfus Organ. 2013; 10(1):12-9.
Bameshki A, Karimi SA. Comparisonal evaluation of reserved blood to transfuse blood for different surgical procedures and definition of maximal surgical blood order schedule. Med J Mashhad Univ Med Sci. 2002; 45(77):21-4.
Gharah BA, Hatami H, Emami H, Bardeh M, Karimi G. Evaluation of blood utilization in Rasht. Sci J Iran Blood Transfus Org. 2010; 7(2):101-8.
Tesic I, Velisavljev D, Martinov D. The type and screen method of blood requisition in General Hospital Zrenjanin. Med Pregl. 2013; 66(1-2):58-63.
Kajja I, Bimenya GS, Eindhoven GB, ten Duis HJ, Sibinga CT. Surgical blood order equation in femoral fracture surgery. Transfusion Med. 2011; 21(1):7-12.
Mahadevan D, Challand C, Clarke A, Keenan J. Maximum surgical blood ordering schedules for revision lower limb arthroplasty. Arch Orthop Trauma Surg. 2011; 131(5):663-7.
Nuttall GA, Santrach PJ, Oliver WC Jr, Ereth MH, Horlocker TT, Cabanela ME, et al. Possible guidelines for autologous red blood cell donations before total hip arthroplasty based on the surgical blood order equation. Mayo Clin Proc. 2000; 75(1):10-7.
Nuttall GA, Horlocker TT, Santrach PJ, Oliver WC Jr, Dekutoski MB, Bryant S. Use of the surgical blood order equation in spinal instrumentation and fusion surgery. Spine. 2000; 25(5):602-5.
Sakurai Y, Okada C. Comparison by simulation of the efficiency of surgical blood order equation (SBOE) with that of maximum surgical blood order schedule (MSBOS). Masui. 2001; 50(1):69-75.
Goundan A, Kalra JK, Raveendran A, Bagga R, Aggarwal N. Descriptive study of blood transfusion practices in women undergoing cesarean delivery. J Obstet Gynaecol Res. 2011; 37(10):1277-82.
Bameshki A, Taghavi GM, Tolou HH, Chitgar RF. Necessary blood volume requirement during debridement and skin graft in burn patients. Sci J Iran Blood Trans Org. 2009; 6(2):125-30.