Naslov
Evaluation of blood ordering in surgical patients in a tertiary care hospital in Zagreb, Croatia

Autori
Jagnjić, Sandra ; Kruhonja Galić, Zrinka ; Lukić, Martina ; Vuk, Tomislav ; Strauss Patko, Maja ; Jukić, Irena

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Vox Sanguinis, Volume 112, Supplement 1 / Devine, Dana V. - Oxford : Wiley-Blackwell, 2017, 261-261

Skup
27th Regional Congress of the ISBT

Mjesto i datum
Kopenhagen, Danska, 17.06.2017. - 21.06.2017

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
blood ordering, C/T ratio, surgical patients

Sažetak
Background: Limited availability of blood and blood components, increased demands for blood products and rising costs for testing and wastage impose avoidance of unnecessary transfusion. Units of blood, routinely ordered for elective surgical procedures, are not often utilized but are unavailable for cross-matching while reserved for a specific patient. This creates loss of shelf life and wastage of blood. Various strategies have been developed to reduce the inappropriate use of blood. Aim: Evaluation of blood ordering for the most common elective surgeries in Clinical Hospital in Zagreb. The purpose was to improve blood ordering and utilization of blood products and reduce unnecessary preoperatively cross- matching as well as wastage of resources. Methods: Data was collected from January 2015 till December 2016. Hospital Transfusion Unit received requests for cross-match for patients who underwent following procedures: orthotopic liver transplantation (OLT), kidney transplantation, total hip replacement, hemicolectomy, Dixon resection, liver resection and nephrectomy. We had calculated for each procedure cross-match to transfusion ratio -C/T (number of units cross-matched /number of units transfused), transfusion probability (number of transfused patients x 100/ number of cross- matched patients) and transfusion index (number of units transfused /number of patients cross- matched). A C/T ratio of >2 and transfusion probability < 30 are consider to be indicative of significant blood wastage. TI < 0.5 signifies no need for cross-match. Results: During the 2-year period, Hospital Transfusion Unit received a total of 888 requests for cross-match out of which 456 (51.3%) patients were transfused. A total of 7409 units (red blood cells (RBCs) were cross- matched, of which 1708 (23%) units were transfused. This means 77% of units RBCs were unutilized. The overall C/T ratio for above elective surgical procedures was 4.33. There were considerable variations in C/T ratio, depending on the type of surgery performed. The highest C/T was for kidney transplantation as 8.37 followed by nephrectomy (7.66) and Dixon resection (7.49). The lowermost C/T ratio was for total hip replacement as 3.78. The overall transfusion probability and transfusion index were observed as 51.3% and 1.92 respectively. The transfusion index in analyzed elective surgical procedures was above 0, 5 in all procedures except nephrectomy (0, 47) which indicates the need for cross-match in most procedures in this study. All the surgeries had the transfusion probability >30 except Dixon resection. Conclusions: The overall C/T ratio of 4.33 demonstrated that in these surgical procedures the preoperative assessment of blood requirements led to over-ordering of blood. However, we are aware that for extensive abdominal surgeries (eg. expanded malignancy diseases) it is difficult to assess blood loss before exploratory laparatomy. We are planning, in collaboration with surgeons and anesthesiologists, to improve the efficacy of ordering and utilization of blood products by formulation the maximum surgical blood ordering schedule for these procedures and all other elective surgical procedures in this Clinical Hospital.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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