To evaluate hemoglobin thresholds of elective surgical patients and blood typing policy for reducing the erythrocyte transfusion in a hospital setting

Abstract

Introduction: The existing methods to quantify blood requirement in elective surgical procedure are the baseline hemoglobin (Hb) and hematocrit of patients. The risk-based scoring systems available are maximum allowable surgical blood loss and maximum surgical blood ordering schedule employ retrospective data evaluation or patient-specific variables, respectively. The aim of the present study was to evaluate a single institutional data for analyzing red blood cell (RBC) requirement among various surgical diagnoses. The study also evaluated RBC threshold for blood transfusions and efficacy of blood typing policy toward reducing unnecessary transfusions in an institution. Study Design and Methods: This study is a retrospective data evaluation from a single institution of blood transfusion patterns among elective surgical patients. Results: The blood transfusions in surgical diagnoses (n = 259) got integrated under 16 categories. The overall crossmatch-to-transfusion ratio was 1.4, average Hb before transfusion was 9.0 g/dl across the surgical categories, and average erythrocyte transfusion per patient for the various clinical diagnoses was 0.4 blood units. The effective Blood usage was 73.2% of requisitions received and blood typing was performed in 46.3% of total requisitions. Blood typing policy showed a statistically significant improvement in the blood transfusion of crossmatched units in the hospital. A per-unit reduction of blood cost in patients was also observed. Conclusions: The blood transfusion across the surgical categories showed similar Hb thresholds before transfusion. Blood typing policy improved EBU and reduced unnecessary crossmatches and transfusion costs among the patients.