An Audit of Surgical Blood Ordering Practices at a Tertiary Care Centre in Western India

Dr Joseph Philip; Dr A K Biswas

Volume : VII, Issue : II, February - 2017

An Audit of Surgical Blood Ordering Practices at a Tertiary Care Centre in Western India

Dr Joseph Philip, Dr A K Biswas

Abstract :

Background: Appropriate and rational use of blood is required to ensure its availability to needy patients as well as to avoid unwanted risk of transfusion transmitted diseases. Aim and Objectives: To analyze the demand and utilization of packed red blood cells (PRBCs) in a tertiary care hospital, to advocate a rational blood ordering practice in different surgical services, with the objective to avoid man–hour and material wastage, to reduce artificial paucity of blood units, and thus preventing unnecessary exposure of the patients to various undesired hazards of transfusions. Materials and Method: In this five year retrospective study (2011–2015), data pertaining to the demand and utilization of PRBCs in various surgical sub–specialties were analyzed from bank records and were then correlated with crossmatch to transfusion ratio (CT), transfusion probability (TP) and transfusion index (TI). Results: A total of 45766 patients were studied over a period of 05 years, who underwent various elective procedures in various surgical sub–specialties. Of the total 55700 PRBC units cross–matched pre–operatively, only 31809 units (57%) were transfused to 35679 patients. This resulted in 43% of the total crossmatched units not being transfused. Maximum requirement as per the PRBC demands pre–operatively was for cardiothoracic surgeries (45%), followed by oncological (15.5%) & obstetrical/gynecological (O&G) (7.2%) indications. Blood transfused was maximum for cardiothoracic surgeries (52.6%), followed by oncological (18%) and general surgeries (10%). A high CT ratio was observed in O&G (3.6) and orthopedic (2.4) specialties. Low values of TI were observed in O&G (0.23) and gastroenterological surgery (0.57). Minimum values of TP were observed for O&G (43.9%) and orthopedic (46.8%) specialties. Conclusion: There was a considerable difference in demand and utilization of PRBCs. Hospital transfusion committee, periodic audits and implementation of maximum surgical blood order schedule can play an important role to monitor the correctness and efficient use of this product in any hospital.