Blood Usage Research Articles

Narrative review of blood management in the cancer patient undergoing surgery

: Improvements in cancer screening programmes and diagnostics have meant that many cancers are now identified early in the disease process and therefore surgery can offer a potential cure. The incidence of cancer continues to increase worldwide and as does the need and capability for surgery. All surgery comes with a risk of blood loss and transfusion. Patient blood management (PBM) is now recognised as a multi-disciplinary team approach and has evolved over the last decade. Using a phased framework of pre-, intra- and post-operative pillars it aims to facilitate early identification and treatment of modifiable risk factors for peri-operative blood loss and thus reduce unnecessary blood transfusion. Anaemia is more prevalent in patients with underlying cancer, so the effects of significant peri-operative blood loss can be more profound and leads to increases in morbidity and mortality. Pre-operative anaemia is an independent risk factor for requiring a blood transfusion. Anaemia can arise from a number of causes; primary pathology, adjuvant chemotherapy and malnutrition are particularly prominent in a cancer setting. Pre-operative treatments include the use of blood, erythrocyte stimulating agent and intravenous iron therapy. Whilst allogenic blood transfusion might always remain a necessity where pre-operative anaemia is extreme or where there is catastrophic intra-operative blood loss, attention to early identification and intervention can modify blood usage. Intra-operative strategies for reducing transfusion in surgery may include advanced technologies such as cell salvage. Post-operatively adherence to transfusion threshold guidance can further reduce transfusion requirements.

Transfusion pattern of blood products in a blood bank at a tertiary care hospital

Objectives: Blood products in modern-day transfusion practice include, Packed Red Blood Cells, Platelets, Leucocytes, Plasma, Cryoprecipitate, and individual plasma factors. The objective was to study the pattern of usage of various blood products for the commonest clinical indications and to have an overview of the production of blood components. Materials and Methods: In this study, usage of various blood products like Packed Red Blood Cells, Platelet concentrates, Fresh Frozen Plasma, and Cryoprecipitate were studied in the blood bank of Trichy SRM medical college hospital and research center, using blood bank records and correlating with clinical data during the period of June 2015 - June 2020. Observation and result: The pattern of usage among 14,511 units of blood components from June 2015 – June 2020 showed the frequency of usage of Packed Red Blood Cells was more than Fresh Frozen Plasma and whole blood. The usage of whole blood was more than Platelet concentrates and Cryoprecipitate. The most frequently used component was Packed Red blood cells – 7841 units (54%). The second most frequently used component was fresh frozen plasma – 3889 units (26.8%). In the next frequency whole blood- 1955 units (13.5%), platelet concentrates - 797 units (5.5%) and cryoprecipitate – 29 units (0.2%) were used. Conclusion: There has been an appropriate increase in the usage of blood products to meet the clinical demand in treating the patients with an increase in pathological conditions. Specific blood component transfusion should be encouraged for specific indications to reduce non-essential overload to the patients.

Tools for rapid analysis of blood usage and inventory during the COVID-19 pandemic.

The COVID-19 pandemic caused downtrends in both blood collections and blood usage. Rapidly visualizing the impact of the pandemic and newly implemented hospital policies on usage could potentially inform blood ordering practices to help avoid wastage. Blood usage data were obtained from the laboratory information system. An R-based workflow was written in R Markdown for analysis and visualization. Reports were generated daily and shared with blood bank leadership. Selected reports were shared with institutional leadership, other departments, and collaborating blood suppliers. Mean daily transfusions dropped 42% from 3/9-13 to 3/16-20, with a significant decrease in usage of red cells, plasma, and cryoprecipitate. The greatest decline in use was seen in the general operating rooms, whereas outpatient transfusions remained steady. Weekly total blood usage decreased through the end of March into April and returned to normal levels in May. During two 5-weekday periods of changing hospital policies, overall blood usage decreased by almost half. Visualization of usage by hospital location showed a large decrease in general operating room usage after cancellation of elective procedures. This data visualization has informed decisions to modify standing product orders during an initial period of decreased usage as well as return to normal orders in later months.

Vox Sanguinis International Forum on Hospital Transfusion Services' Response to COVID‐19: Responses

Question 1Demographics:a. Beer Yaakov, Israel.b. Large academic medical center.c. 956 beds.d. 9034 RBC units issued in 2019, approximately 9000.e. 4831 confirmed SARS‐CoV‐2 cases and 17 deaths (March 31, 2020, 12:40 pm, data from the Israeli Ministry of Health).f. 9,136,000 inhabitants.g. The spread of SARS‐CoV‐2 in Israel is still increasing, but as of yesterday the rate of increase is declining sharply (from almost 30% of samples tested per day at the peak to 12% yesterday).

Analysis of Patterns of Adverse Transfusion Reactions and Management: A Novel Initiative toward Hemovigilance in a Teaching Hospital of South India.

Objective Blood transfusion being a major lifesaving frontline procedure in majority of clinical wards, has a high potential with risk for adverse events ranging in severity, thus warranting optimal usage of blood. Continuous monitoring of adverse transfusion reaction (ATR) and analysis of the reactions can promote better comprehension of various contributing risk factors. Hemovigilance being a quality indicator with data system assists in ensuring quality and safe blood transfusion. The present study was designed to analyze the incidence and nature of adverse transfusion-associated events reported to the blood bank from our teaching hospital located in the remote part of South-East Coastal region with emphasis on corrective and preventive actions. Materials and Methods The prospective study included all the ATR reported to our hospital blood bank over a period of 42 months. The transfusion reactions report forms filled by the clinicians were analyzed and the reactions were categorized into patterns. The associated risk factors for the reaction are evaluated with substantial laboratory and clinical parameters in reference to hemovigilance. Results Among 19,800 transfusions, 189 transfusion reactions were encountered with a ratio of 10:0.9 with age ranging from 12 to 80, with female preponderance. Reactions associated with whole blood (WB) transfusion were common (50%, p = 0.002) followed by packed red blood cells transfusion (PRBC) (1.4%, p = 0.006) and platelets (0.8%, p = 0.1). Febrile nonhemolytic transfusion reactions were predominant patterns noted in 122 cases followed by allergic reactions in 43 cases with more commonly associated PRBC transfusion whereas hemolytic reactions showed association with WB transfusion. No delayed reactions or mortalities were encountered. Conclusion The present study concludes with novelty showing the overall incidence of transfusion-associated reactions in the study domain is slightly higher than more advanced centers in India owing to lack of leukodepletion units which could enable to substantially retard the incidence of adverse events of transfusion as a general measure and febrile reactions in particular. Hemovigilance and pattern analysis of ATR provide scope for corrective and preventive action and give referral guidelines to prevent future recurrence.

COVID-19 insights from transfusion medicine.

The emergence of CoVID‐19 infection in the first months of 2020 resulted in a massive surge in admissions to hospitals and intensive care units due to the nature of the respiratory pathophysiology. In some countries, health care systems were rapidly overwhelmed, while in others their hospitals coped with the first wave and all patients received the level of care needed, depending upon both the containment measured and the level of development of the heath care systems.

Impact of Training to Improve Knowledge on Blood Transfusion among Health Care Providers from Tertiary Hospitals in Tanzania

Background: Blood transfusion is a lifesaving therapy which is linked to the adverse outcome when given inappropriately. Inadequate knowledge and skills among health care providers have been reported to contribute to safety issues for recipients and wastage of the precious resource. This study was conducted to determine the impact of training of health care providers in Tanzania on improving the knowledge regarding the transfusion of blood and blood components.Methodology: This was a cross-sectional study which used secondary data from pre and post training assessment questionnaire whereby trainees answered the same set of questions before training (pre-test) and after training (post-test). The questionnaire consisted of two Likert scale questions and eight YES/NO questions which assessed the perception of clinicians, nurses and Laboratory personnel on blood transfusion practices. Moreover, there were thirty multiple-choice questions for assessment of basic knowledge related to usage of blood and blood components.Results: One hundred and eleven (111) health care providers who attended training on blood transfusion were recruited into this study, out of which 72.1% (80/111) were from secondary health care facilities and 6.3% (7/111) were from tertiary health care facilities. The pre-test mean percent score was 32.8% (SD ±12.9%), while the post-test mean percent score was 56.6% (SD ±12.9%). The mean percentage of knowledge gain was 26.6% (SD±13.0%) and 27.1% (SD±12.5%) for health care providers and National Blood Transfusion Service staff respectively. It was observed that only 25.8% (24/93) and 19% (19/100) of participants were aware of the transfusion timing of various blood components and principles of platelet transfusion, respectively. Regarding bedside blood handling practices, only 52.9% (46/87) responded, ‘warm whole blood unit and packed red blood by putting under room temperature for 30 minutes and the majority of participants 63.1% (65/103) reported not to ask for consent before blood transfusion.Conclusion: There was a modest improvement in the knowledge on blood transfusion practice among participants. The overall performance of participants increased from 33% in the pre-test to 57% in the post-test. Therefore, this study has shown the positive impact of training for health care providers in improving their knowledge. We recommend regular on job training courses and mentorship program for health care providers for proficiency in clinical transfusion practice.
 Key words: Blood Transfusion, Training and Health care providers.

Blood transfusion utilization in hospitalized COVID-19 patients.

BackgroundThe acute respiratory illness designated coronavirus disease 2019 (COVID‐19) was first reported in Wuhan, China, in December 2019 and caused a worldwide pandemic. Concerns arose about the impact of the COVID‐19 pandemic on blood donations and potential significant blood transfusion needs in severely ill COVID‐19 patients. Data on blood usage in hospitalized COVID‐19 patients are scarce.Study Design and MethodsWe performed a retrospective observational study of blood component transfusions in the first 4 weeks of COVID‐19 ward admissions. The study period began 14 days before the first COVID‐19 cohort wards opened in our hospital in March 2020 and ended 28 days afterward. The number of patients and blood components transfused in the COVID‐19 wards was tabulated. Transfusion rates of each blood component were compared in COVID‐19 wards versus all other inpatient wards.ResultsCOVID‐19 wards opened with seven suspected patients and after 4 weeks had 305 cumulative COVID‐19 admissions. Forty‐one of 305 hospitalized COVID‐19 patients (13.4%) received transfusions with 11.1% receiving red blood cells (RBCs), 1.6% platelets (PLTs), 1.0% plasma, and 1.0% cryoprecipitate (cryo). COVID‐19 wards had significantly lower transfusion rates compared to non‐COVID wards for RBCs (0.03 vs 0.08 units/patient‐day), PLTs (0.003 vs 0.033), and plasma (0.002 vs 0.018; all p < 0.0001). Cryo rates were similar (0.008 vs 0.009, p = 0.6).ConclusionsHospitalized COVID‐19 patients required many fewer blood transfusions than other hospitalized patients. COVID‐19 transfusion data will inform planning and preparation of blood resource utilization during the pandemic.

Perioperative blood usage and therapeutic plasma exchange in kidney transplantation during a 16-year period in South Korea.

The frequency of kidney transplantation (KT) is increasing. Blood transfusion plays an important role in the success of KT. Therapeutic plasma exchange (TPE) is also used for desensitisation in ABO-incompatible KT and treatment of antibody-mediated rejection. We analysed red blood cell (RBC), platelet, and fresh frozen plasma (FFP) usage and the number of TPE procedures performed during the hospitalisation of KT patients from 2002 to 2017 using the Korean National Health Insurance Service-National Health Information Database. A total of 18,331 KT patients were included in this study. The number of transfused RBCs continued to increase from 4,806 units in 2002-2005 to 12,390 units in 2014-2017. However, the average number of RBCs transfused per patient decreased from 2.17 to 1.79 units. Estimated platelet usage increased from 4,259 units in 2002-2005 to 11,519 units in 2014-2017, and the proportion of filtered platelets increased from 72.6% to 83.4% during the same period. There was a huge increase in the total number of FFP units used, from 2,255 units in 2002-2005 to 51,531 units in 2014-2017. The number of TPE procedures performed also increased from 296 to 6,479 during the same period. Patients with acute rejection accounted for 8.8% of all KT patients, and more RBC and FFP were used for these patients and a greater number of TPE procedures were performed compared to those who did not experience rejection. Blood usage and TPE have increased steadily with the increasing numbers of KTs. Therefore, continuous efforts are needed to ensure appropriate perioperative blood preparation and usage for KT patients.

Wastage of Blood Units at Tertiary Care Hospitals of Lahore.

Introduction: Blood and its products are the most valuable resource in every healthcare institution. Judicial use of these limited resources is necessary and important to maintain sufficient supply. Blood products and its transfusion system are being evaluated by the use of several markers. The use of crossmatch to transfusion ratio (C/T) was first proposed by Boral Henry in 1975. Nowadays, the C/T ratio is being used by researchers to assess transfusion practices. Ideally, (C/T) ratio has to be 1.0 but it has been suggested that a ratio of 2.5 or less would indicate effective blood use.Objective: To assess crossmatch to transfusion ratio (C/T ratio), transfusion probability (%T), and transfusion index (TI) in patients of medical and surgical wards. To assess the wastage of blood components/whole blood units.Methods: A cross-sectional study was conducted at Mayo Hospital/King Edward Medical University, Lahore, Services Hospital Lahore, and Alkhidmat Blood Bank Surrayya Azeem Hospital between January 2019 and June 2019. Nonprobability convenient sampling was performed and all collected data were entered and analyzed by using statistical package for social sciences (SPSS version 20).Results: The total patients who were ordered to arrange blood were 1322 for which overall 2715 crossmatches had been done. Among these crossmatches, a total of 1536 of the donors were bled for from which only 815 units had been transfused to the patients. Overall C/T ratio was found to be 3.33 and the overall wastage was 38.9%.Conclusions: Blood transfusion is considered useful in the management of surgical as well as medical patients. Too many units are ordered out of which the majority are wasted due to nonutilization. There is a need for standard operating procedures for transfusion of blood. There shall be regular audits to improve the blood collection, treatment, delivery, and usage practices of this scarce resource.

Prepare to adapt: blood supply and transfusion support during the first 2 weeks of the 2019 novel coronavirus (COVID-19) pandemic affecting Washington State.

The first coronavirus (COVID-19) case was reported in United States in the state of Washington, approximately 3 months after the outbreak in Wuhan, China. Three weeks later, the US federal government declared the pandemic a national emergency. The number of confirmed COVID-19 positive cases increased rather rapidly and changed routine daily activities of the community. This brief report describes the response from the hospital, the regional blood center, and the hospital-based transfusion services to the events that took place in the community during the initial phases of the pandemic. In Washington State, the first week of March started with four confirmed cases and ended with 150; by the end of the second week of March there were more than 700 cases of confirmed COVID-19. During the first week, blood donations dropped significantly. Blood units provided from blood centers of nonaffected areas of the country helped keep inventory stable and allow for routine hospital operations. The hospital-based transfusion service began prospective triaging of blood orders to monitor and prioritize blood usage. In the second week, blood donations recovered, and the hospital postponed elective procedures to ensure staff and personal protective equipment were appropriate for the care of critical patients. As community activities are disrupted and hospital activities switch from routine operations to pandemic focused and urgent care oriented, the blood supply and usage requires a number of transformations.

Economic value of clinical decision support allied to direct data feedback to clinicians: blood usage in haematology

Responding to national and local pressures to reduce the amount of blood transfused, the haematology department of Oxford University Hospitals (OUH), UK implemented an electronic blood-ordering system with clinical decision support. This intervention targeted junior doctors, giving regular feedback on their transfusion practices with respect to clinical guidelines. We evaluated the incremental costs of the intervention using interrupted time series methods to compare red blood cell and platelet usage before and after the intervention was implemented. Difference-in-differences analysis was used to control for external factors that would affect the use of blood products over time. Reductions in blood usage were balanced against intervention costs. The base case analysis showed an average cost saving to the department of £89304 annually as a result of the intervention. Scenario analyses suggested that the savings may have been greater still, had the increasing trend in blood use prior to the intervention continued in the absence of the intervention. An electronic blood-ordering system with clinical decision support can reduce blood transfusions and associated healthcare costs. Focusing on improving junior doctors' transfusion practice is expected to have a knock-on benefit in terms of dissemination of good transfusion practice both within their own department and others as they continue their training.

The impact of organisational change on transfusion practices in perioperative care: an analysis of blood product use following the merger of three London cardiac surgery units to form the Barts Heart Centre

In 2015, three London cardiac centres, with different transfusion infrastructure support, merged to form the Barts Heart Centre. We describe the impact on transfusion rate, blood usage and interoperator variation. Data was collected on all adult patients undergoing cardiac surgery during 2014 as well as 2016, using the National Institute Cardiovascular Outcomes Research (NICOR) data set. Over the two time periods, a total of 3,647 cardiac procedures were performed (1,930 in 2014 and 1,717 in 2016). There were no significant differences in type of surgery or patient comorbidity between the two epochs of time. Overall, red blood cell transfusion at 24 hours and until hospital discharge reduced significantly in 2016 (odds ratio 0.77; 95% confidence interval 0.68-0.89; p=0.0002). Interoperator variability (adjusted for comorbidities) reduced after merger from standard deviation 0.394 (standard error (SE) 0.096) to 0.269 (SE 0.082), p=0.001. Clinical and organisational factors can improve transfusion service.

An Evaluation of the Practice for the Requisition of Blood Products and its Utilization in Neurosurgical Patients Undergoing Elective Surgery at a Tertiary Care Hospital.

Background:Neurosurgical procedures are associated with profound blood loss that necessitates need for intraoperative and postoperative blood transfusion. Excessive ordering of blood based on physicians' habitual practice may lead to unintentional misuse of blood bank services. For the optimal use of blood resources, transfusion practices have to be appropriate.Aims:The aim of this study is to study the cross match to transfusion ratio and to review the blood utilization practices (transfusion index and maximal surgical blood order schedule) in elective neurosurgical procedures.Settings and Design:A prospective, observational study comprising 740 patients undergoing elective neurosurgical procedures.Materials and Methods:Blood requisition forms and patient records were analyzed of patients undergoing elective neurosurgical procedures from December 2017 to December 2018. A review and note was made of the patient's age, sex, and diagnosis. The number of units prepared, cross matched, and transfused were noted.Statistical Analysis:Statistical analysis was performed with the IBM SPSS software version 21.0. Blood utilization indices were computed and expressed as percentage.Results:A total of 740 patients underwent elective surgical procedures. Among these, 346 patients were requested to prepare 614 units of blood. Out of these 740 patients, there were 56 patients who were in the pediatric age group. A total of 178 units were transfused in 102 patients. One hundred and forty-two units were transfused in the intraoperative period, whereas as 36 units were transfused in the postoperative period.Conclusion:There is an efficient usage of blood for patients undergoing surgery for meningiomas, posterior fossa tumors, spinal dysraphism, and craniovertrebral junctional anomalies. However, the blood resources were poorly utilized in patients undergoing surgery for subarachnoid hemorrhage and pituitary tumors. A revision of blood transfusion policy within the hospital is needed.

Blood utilization quality indicators in a tertiary care center in South India

Background: Injudicious over-ordering of blood components not only burdens the physical and human resources but also increases the cost of health care. Moreover, such practices have a greater implication in developing countries like ours where there is a scarcity of voluntary blood donors and insufficient blood supply to cater to increasing demands. Therefore, there is a need for continuous monitoring of the utilization of blood components and to audit the transfusion practices to identify areas of concern for blood usage. Ours is a 1600 bedded super specialty health center with 100% bed occupancy. The objective of the study was to analyze the trend of utilization of blood components and transfusion practices by various medical and surgical specialties by determining the blood utilization quality indicators at our center. Methods: This was a retrospective and cross-sectional study done over a period of 7 months from January 2018 to July 2018. The data for blood utilization quality indicators in the first half can be taken as the representative of the entire year. The data pertaining to the number of requisitions received as well as cross-matches done and issues made were collected from transfusion requisition forms, cross-match, and issue registers and analyzed. The parameters used in the analysis were crossmatch to transfusion ratio (CT ratio), transfusion index (TI), and transfusion probability (%T). Results: During the 7-months study period, a total of 28,317 transfusion requisitions were received and 34,701 blood components were issued. The total cross-matched red blood cell (RBC) units were 10,861 and the total RBC units transfused were 10,066. The overall C/T ratio was found to be 1.57. The transfusion probability (%T) and TI were calculated as 79% and 1.18, respectively, in our study. Conclusion: The CT ratio, transfusion probability, and TI demonstrated that there is an efficient blood utilization at our center. Regular auditing of blood transfusion services should be practiced at every hospital wherein the Maximum Surgical Blood Ordering Schedule can be modified and implemented progressively, following evidence-based blood transfusion guidelines.

A retrospective analysis of blood requisition versus utilization practices at national blood bank, jigme dorji wangchuck national referral hospital, Thimphu, Bhutan

Background and Objectives: Although National Guidelines on Clinical Use of Blood has been developed, it is a common practice to order blood based on the subjective anticipation of blood loss, instead of evidence-based requirement at National Referral Hospital, Thimphu. However, National Blood Bank follows the maximum surgical blood ordering schedule, thereby saving the resources and making blood available for emergency patients. Nonetheless, the need-based assessment is not conducted to determine the efficacy of the practice. This study aimed to assess the effectiveness of the current practice of following the national guidelines on maximum surgical ordering of blood by evaluating the blood requisition versus utilization practice. Materials and Methods: A hospital-based retrospective study was conducted at national blood bank over a 1-year period (January–December 2018). Demographic data, such as age and sex, and clinical wards with maximum transfusion done were recorded. Blood utilization indices were computed for cross-match-to-transfusion ratio (C:T, <2.5), transfusion index (TI, >0.5) and transfusion probability (%T, >30) to indicate significant blood usage. All data were processed and analyzed with software programs Microsoft Excel 2013 and GraphPad Prism (v 7.04). Results: Of 4012 blood units cross-matched, 3205 blood units were transfused to patients (C:T ratio 1). Majority (65.33%) of the patients were females and 34.66% were males. The overall TI was 1.49 and %T was 73.07%, implying significant blood usage. The maximum request for blood was made from gynecological and obstetrics ward, emergency, and daycare blood transfusion unit. Similarly, the patients transfused with the cross-matched units were also found to be highest for these wards. Conclusion: The study demonstrates that the current practice of maximum blood ordering schedule is effective in saving valuable time and resources. However, there is a need to sensitize the requesting physician on rational order for effective management of the blood inventory.

A Non Invasive Diabetes Diagnosis using a Motor Device

Along with the advancement in Biomedical technology to cure many commons, but there is certain lethal disease spanned in the world which has no cure for it. One such is Diabetes, although it does not have any remedy, at least it has controlling and diagnosing methods. It is a type of disorder in body metabolism where there is a high blood sugar level for sustained period. Diabetes is a condition in which there happened to be high blood sugar levels over a longtime. Symptoms are repeated urination, thirst, and hunger. If left unchecked, it may cause many complications. Acute complications include ketoacidosis, or death. The Diabetes can be analysed by gaining a drop of blood from test subject and blending it with biosensor. This method is compact and modest, but it happens to be an intrusive and contaminant method as it deals with the usage of blood. This assumption sparked us to progress a non-invasive method of diagnosing the diabetes level for a patient using their foot sensitivity. This advancement helps one to obtain the same test result but with a non-invasive practise, which gives a painless and non-contaminant diagnosis.

Efficiency of blood utilization in elective surgical patients

BackgroundRequesting blood prior to a surgical procedure for perioperative transfusion is a common practice in surgical patients. More unit of blood is requested than used by anticipating the patient will be transfused to provide a safety margin in an event of unexpected haemorrhage. Over requesting with minimal utilization results in significant wastage of blood, reagents and human resource. This study was conducted to assess blood utilization practice of the largest tertiary hospital in Ethiopia.MethodsA cross-sectional prospective study method was used. Data was collected using a Proforma questionnaire by perusal of each individual patient’s records from December 1, 2017 to February 28, 2018.patient age, sex, department requesting the blood, level of operating surgeon, hemodynamic status, number of unit requested, number of unit crossed matched and number of unit transfused were collected. Efficiency of blood utilization was calculated with three indices: Crossmatch to transfusion ratio, transfusion probability, and transfusion index indices.ResultsBlood was requested for 406 patients and a total of 898 units were crossmatched for this patients. Overall Crossmatch to transfusion ration, transfusion probability and transfusion index were 7.6, 15.3% and 0.29 respectively. Results showed insignificant blood usage. Among different departments and units, better blood utilization was seen in neurosurgical unit with C/T ratio, TP and TI of 4.9, 24.4 and 0.6% respectively, while worst indices were from obstetrics unit with C/T ratio, TP and TI of 31.0, 6.5% and 0.06.ConclusionUsing all the three parameters for evaluation of efficiency of blood utilization, the practice in our hospital shows ineffective blood utilization in elective surgical procedure. Blood requesting physician should order the minimum blood anticipated to be used as much as possible.

Determinants of blood transfusion for elective surgical procedures at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2017

BackgroundTill date 80% of the world's population has access to only 20% of the world's safe blood that is properly collected and tested. Paradoxically, despite a severely inadequate supply, blood is often transfused unnecessarily and it will expose patients to complications. Despite lots of publication and investigation on the efficiency of blood usage, there is no clear demarcation which patients really need blood transfusion. ObjectivesTo determine factors associated with blood transfusion in elective surgical procedures in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2017 G.C. MethodsHospital based cross sectional study was conducted from February 1, 2017 to September 30, 2017 G.C at Tikur Anbessa specialized Hospital. Data was collected by using convenient sampling technique and structured checklist. Multivariate logistic regression analysis was conducted to identify significant predictors of transfusion based on p-value less than 0.05 with 95% confidence level. ResultsAmong all 387 elective surgical patients 88 (22.7%) of patients were transfused with prepared blood. The independent predictors of perioperative blood transfusion were neurosurgery (craniotomy) (p = 0.017), hemoglobin level < 11.0 g/dl (p < 0.001) and intraoperative blood loss ≥ 15% (P < 0 0.001). Conclusionneurosurgery, hemoglobin <11.0 g/dl and intraoperative blood loss ≥15% were the major determinants of blood transfusion.

Адміністративна процедура у царині донорства крові та її компонентів

Адміністративна процедура у царині донорства крові та її компонентів