Pre-Operative Prescription of Erythrocyte Concentrates in Surgery and Gyneco-Obstetrics at Cuk

Abstract

Background: The practice of blood transfusion is common at the University Clinics of Kinshasa (CUK), with a trend towards a decrease in average transfusion rates between 2015 and 2016. However a gap persists between the still insufficient donation and the needs in blood derivatives. Objective: The objective of this work was to assess the level of need according to the efficient management of red cell concentrates and according to certain bioclinical components. Methods: A literature review was conducted in patients operated in Surgery and Obstetrics-Gynaecology during the period of January 2014 to December 2016. The Haematology and Immuno-transfusion unit of CUK were used as reference for the Surgical and Obstetric Gynaecology Services. Results: In a total of 1512 patient records from the two surgical departments analysed, the mean pretransfusion haemoglobinemia was 9.6 ± 2.5g/dL. Unjustified prescriptions and unjustified expenditures were more associated with Surgery, Obstetrics and restrictive transfusion strategy. Advanced age, preoperative haemoglobinemia collapse and surgical services were independent predictors of the number of bags ordered. Conclusion: Inadequate prescribing of unwarranted blood bags was pejorative in patients transfused from a low socioeconomic level. Further prospective studies are needed. They could include other parameters not addressed in this study such as the quality of the prescriber, the surgeon who operated and the duration of delivery of the unit ordered.