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. 2022 Sep;13(3):474-480.
doi: 10.1007/s13193-022-01512-y. Epub 2022 Jan 25.

Efficiency of Blood Utilization in Elective Oncosurgeries in a Tertiary Care Cancer Centre: A Case for Data Disaggregation

Shalini Bajpai  1 , Aveek Jayant  1
Affiliations

Efficiency of Blood Utilization in Elective Oncosurgeries in a Tertiary Care Cancer Centre: A Case for Data Disaggregation

Shalini Bajpai et al. Indian J Surg Oncol. 2022 Sep.

Abstract

Oncosurgeries based on radical resection significantly increase the chances of intraoperative blood transfusion which leads to blood requisition based on subjective anticipation. Periodic audit and revisiting practice based on disaggregating data on the basis of surgical region could preserve blood, which is a scarce resource globally. This report proposes to use the results for reviewing the existing blood ordering schedule, in addition to proposing wider adoption in other cancer institutes using this report as a template. A retrospective analysis was performed for the entire patient cohort who underwent elective oncosurgeries between January 1, 2020, and January 31, 2021, and for whom blood reservation was done. Number of blood units cross matched and transfused for each patient for each surgery was noted. Efficiency of blood utilization was calculated using cross match transfusion ratio (CTR), transfusion probability (TP), and transfusion index (TI) indices and, finally, maximum surgical blood order schedule (MSBOS) was computed. Out of 718 elective oncosurgeries performed, blood requisition of 710 units was made for 345 procedures. Of the total units cross matched, only 76 units (10.70%) were transfused, leaving 89.29% units unutilized. Overall, CTR, TP, and TI were 9.34, 11.59%, and 0.22, respectively. Head and neck surgeries had the highest number of patients cross matched as well as units reserved, but not transfused. Conversely, abdominal surgeries had the highest transfusion probability. There is inefficient blood utilization in elective oncosurgeries and we recommend implementation of MSBOS based on anatomic region to improve efficiency of blood utilization.

Keywords: Cross match transfusion ratio; Maximum surgical blood order schedule; Transfusion index; Transfusion probability.

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Conflict of interest statement

Conflict of Interest The authors have no relevant financial or non-financial interests to disclose. The authors have no competing interests to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Pie chart showing units transfused and units cross matched but not transfused, i.e. unutilized
See this image and copyright information in PMC

References

    1. Franchini M, Marano G, Veropalumbo E, Masiello F, Pati I, Candura F, et al. Patient blood management: a revolutionary approach to transfusion medicine. Blood Transfus. 2019;17(3):191–195. - PMC - PubMed
    1. Ecker BL, Simmons KD, Zaheer S, Poe S-LC, Bartlett EK, Drebin JA, et al. Blood transfusion in major abdominal surgery for malignant tumors: a trend analysis using the national surgical quality improvement program. JAMA Surg. 2016;151(6):518. doi: 10.1001/jamasurg.2015.5094. - DOI - PubMed
    1. Luke L, Ranmuthu CKI, Ranmuthu CDS, Habeeb A, Appukutty J, Irune E. Blood transfusion demands in a tertiary otolaryngology, head and neck centre: A 5- year retrospective cohort study. Transfus Med. 2021 doi: 10.1111/tme.12822. - DOI - PubMed
    1. Sowayan SA. Use of blood in elective surgery: an area of wasted hospital resource. Ann Saudi Med. 1994;14:326–328. doi: 10.5144/0256-4947.1994.326. - DOI - PMC - PubMed
    1. Roberts N, James S, Delaney M, Fitzmaurice C. The global need and availability of blood products: a modelling study. Lancet Haematol. 2019;6(12):e606–e615. doi: 10.1016/s2352-3026(19)30200-5. - DOI - PubMed

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