Comparison of Safety and Cost of Cross-match Tests and Antibody Screening before Blood Transfusion in Patients Undergoing Orthopedic Surgery: A Cross-sectional Study

Abstract

Introduction: Planning for blood request and balancing supply and demand are still contentious issues in hospitals and blood transfusion centers. This study aimed to compare the safety and cost-effectiveness of two pre-transfusion tests for red blood cells in patients undergoing orthopedic surgery. Method: In this descriptive-analytical cross-sectional study, patients undergoing surgery who required blood transfusion during the operation were included via convenience sampling method. The necessary information for this study was collected using a researcher-made checklist consisting of two parts: background information, blood bag information, and information related to potential complications. The cost estimation of the tests was also extracted using the records. The findings were analyzed using descriptive and inferential statistics with SPSS software (version 18), and the significance level was set at 0.05. Results: A total of 212 patients with a mean age of 44.98 years were included in the study. Cross-match was performed for 108 patients (50.9%), and antibody screening test was used for 104 patients (49.1%). Regarding complications after blood transfusion, at least one sign was observed in 12 patients (5.7%). Jaundice, fever, and itching were the most common symptoms. The cross-match to transfusion (C/T) ratio was higher than international standard criteria (5.25 vs. 2.5). Conclusion: The results of this study demonstrated that the safety and accuracy of both pre-transfusion methods were similar, and no significant difference was observed. However, the cross-match test was more cost-effective compared to the match antibody screening test.