Abstract
Introduction: Blood component transfusions form a vital role in the resuscitation and management of both medical and surgical patients. Treating doctors tend to over-order blood components in surplus of utilization. Policies for ordering a transfusion may be put into practice based upon audits, discussion and agreement made by the Hospital Transfusion Committee (HTC).
Methodology: A prospective study was undertaken for a period of 18 months in the department of transfusion medicine at a tertiary care teaching hospital. The data was collected from blood component request forms and blood-reserve & issue registers in the hospital blood bank. Blood utilization indices [Crossmatch/Transfusion Ratio (C/T Ratio), Transfusion Probability (%T) & Transfusion Index (TI)] were computed. Data were entered in MS excel and analyzed using SPSS version 20.
Results: During the study period, the department of transfusion medicine received 6197 crossmatch request forms for 1198 patients. From 6197 units crossmatched, 1040 (16.8%) were transfused and the rest of the crossmatched units were temporarily removed from main stock. The blood units prepared per patient ranged from one to eight units. The complete blood utilization indices of the hospital were C/T ratio of 5.95, %T of 67.7% and TI = 0.87 respectively.
Discussion: Blood transfusion indices of the present study were optimal but comparatively higher as most of the crossmatched blood was not utilized. Developing a structured blood transfusion policy by the Hospital transfusion committee will pave way for better blood inventory, efficient blood utilization and financial savings.
Keywords: Blood component transfusions, Hospital transfusion committee (HTC), Blood utilization indices, Crossmatch/Transfusion Ratio (C/T Ratio), Transfusion Probability (%T), Transfusion Index (TI)
References
- Friedman BA, Oberman HA, Chadwick AR, Kingon KI: The maximum surgical blood order schedule and surgical blood use in the United States -Transfusion 1976; 380–387.
- Bhutia SG, Shrinivasan K, Ananthakrishnan N, Jayathi S, Ravishankar M: Blood utilisation in elective surgery- requirements, ordering and transfusion practices - Natl Med J India 1997; 10:164-168.
- 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; 51:251–4.
- de Jongh DS, Feng CS, Frank S, Wallace M: Improved utilisation of blood for elective surgery –Surg. Gynecol. Obstet. 1983;156:326–28.
- Mead JH, Anthony CD, Sattler M: Haemotherapy in elective surgery: an incidence report, review of literature and alternatives for guideline appraisal - Am J Clin Path. 1980;74:223–227.
- Directorate General of Health Services, Transfusion Medicine Technical Manual, second edition, 2003: 383-4.
- NHS Executive Better blood transfusion. Circular HSC. 1998;224.
- Vibhute M, Kamath SK, Shetty A: Blood utilisation in elective general surgery cases: Requirements, ordering and transfusion practices - J Postgrad Med. 2000;46:13–7.
- B. Basnet, D. Lamichhane, and V. K. Sharma: A study of blood requisition and transfusion practice in surgery at Bir Hospital - Postgraduate Medical Journal of NAMS.2009;9(2):14–19.
- Z. Ibrahim, H. M. Mamdouh, and A. M. Ramadan: Blood utilization for elective surgeries at main University Hospital in Alexandria, Egypt - Journal of American Science. 2011; 7(6): 683–689.
- Musa AU, Ndakotsu MA, Hassan A, Kilishi A, Kwaifa IK: Pattern of blood transfusion request and utilization at a Nigerian University Teaching Hospital - Sahel Med J.2014;17:19–22.
- Collins RA, Wisniewski MK, Waters JH, Triulzi DJ, Alarcon LH, Yazer MH: Excessive quantities of red blood cells are issued to the operating room - Transfus Med. 2015;25:374–9.
- Subramanian A, Sagar S, Kumar S, Agrawal D, Albert V, Misra MC: Maximum surgical blood ordering schedule in a tertiary trauma center in Northern India: A proposal - J Emerg Trauma Shock. 2012;5:321–7.
- Bashawri LA: Pattern of blood procurement, ordering and utilization in a University Hospital in Eastern Saudi Arabia - Saudi Med J. 2002;23:555–61,
- Olawunmi HO, Bolaji BO: Blood utilization in elective surgical procedures in Ilorin - Trop J Health Sci. 2006;13:15–7.
- Ebose EM, Osalumese IC: Blood shortage situation: An audit of red blood cell order and pattern of utilization – Afr. J Biotechnol. 2009;8:5922–5.
- Murphy MF, Wallington TB, Kelsey P, Boulton F, Bruce M, Cohen H, et al: Guidelines for the clinical use of red cell transfusions - Br J Haematol. 2001;113:24–31.
- Pei Z, Szallasi A: Prevention of surgical delays by pre-admission type and screen in patients with scheduled surgical procedures: Improved efficiency - Blood Transfus. 2015;13:310–2.
- Iyer SS, Shah J: Red blood cell transfusion strategies and maximum surgical blood ordering schedule - Indian J Anaesth.2014;58:581-9.
- Sowayan SA: Use of blood in elective surgery: An area of wasted hospital resource - Ann Saudi Med. 1994;14:326–8.
Corresponding Author
Dr D.Umesh
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DOI: https://dx.doi.org/10.18535/jmscr/v5i12.154
