A retrospective study of transfusion practice: Blood crossmatch ordering in obstetrics

Malik, Sadaf; Anwari, Jamil S.; Alshahrani, Musaed M; Alotaibi, Rashed

doi:10.4103/sjl.sjl_10_17

Cited by 3 publications

(6 citation statements)

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“…There are few studies from Saudi Arabia regarding blood bank utilization, and most include small sample sizes and short follow-up periods [2,[7][8][9][10]. A study on blood bank utilization conducted in our center between 1996 and 2000 showed an average C/T ratio of 2.96, which did not meet the international standards of less than 2, and over-ordering of blood products and cancellation of over 60% of transfusions [7,11].…”

Section: Introductionmentioning

confidence: 99%

Blood utilization and quality indicators at a university hospital in the Eastern Province of Saudi Arabia

et al. 2022

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Background Blood transfusion is a common, essential procedure when treating many different medical and surgical conditions. Efficient utilization of blood bank facilities by frequent auditing is crucial; however, few studies have examined blood utilization in Saudi Arabia. We aimed to review the blood ordering patterns and transfusion practices, and blood bank audit effectiveness at a single center in Saudi Arabia and compare our results with those of a similar study performed in the same center 20 years ago. Materials and methods This study was a retrospective descriptive chart review of all healthy blood donors and recipients from January 1, 2016, to December 31, 2020. We evaluated the crossmatching-to-transfusion ratio (C/T) as an indicator of blood bank utilization and compared the findings with those of the previous study. We also evaluated changes in blood bank utilization during the coronavirus disease 2019 pandemic. Results Findings from 27,414 donors (men, 94.9%; mean age, 32.2 + 9.6 years) showed a 71% increase in blood donations compared to that of 2000. The donations gradually increased over the years, peaking just before COVID-19 pandemic started in March 2020. For 3,836 patients, 13,324 units of blood were crossmatched (average, 3.47 crossmatch/patient), with 23% of the crossmatch requests from surgical departments. The average C/T ratio, transfusion index, and transfusion probability (T%) were 1.37, 2.55, and 73.2%, respectively. The C/T ratio decreased by 54% between 2000 and 2020. During the pandemic, crossmatching decreased by 26% between 2019 and 2020, but with comparable C/T ratio in 2019 (1.45) and 2020 (1.39). Conclusion Our hospital blood bank utilization improved over the past 20 years, showing increased donations, reduced C/T ratio, and increased T%. This improvement emphasizes the importance of blood donation campaigns, blood bank auditing, restrictive transfusion guidelines, and physician education.

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Section: Introductionmentioning

confidence: 99%

Blood utilization and quality indicators at a university hospital in the Eastern Province of Saudi Arabia

et al. 2022

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“…The need to develop or follow a blood order and/or transfusion policy is frequently overlooked. This trend is more common in developing countries where excess ordering of blood has been observed in 40%-70% of all transfusions [ 8 ]. This trend is evident in the findings during the initial phase of our study (2012-2014) where the average excess cross-match was 83.2%.…”

Section: Discussionmentioning

confidence: 99%

“…The CTR, first described by Zewdie et al [ 9 ], is a blood utilization index, which evaluates the efficiency of transfusion policy. The CTR is a benchmark for clinical practice that indicates significant blood usage and is expected to be 2.5 or lower [ 3 , 8 , 10 , 11 ]. It is advised that at least 33% of the cross-matched units should be transfused.…”

Section: Discussionmentioning

confidence: 99%

“…Data analysis was based on the following salient parameters: age of the patient, type of blood (component or WB), transfusion units (multiple or single), indication for transfusion, and number of units cross-matched versus number of units transfused. Lastly, the study computed and scrutinized "blood utilization indices" in accordance with the established guidelines [ 3 , 7 , 8 ].…”

Section: Methodsmentioning

confidence: 99%

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Blood Utilization Trends in Obstetrics and Gynecology: A Seven-Year Retrospective Study in a Teaching Hospital in Sikkim, India

Sharma,

Datta

2023

Cureus

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Introduction: Unutilized cross-matched blood due to excess cross-match requisitions results in unnecessary wastage of inventory, time, labor, and financial resources. This retrospective cross-sectional study aims to assess the blood utilization practices in obstetrics/gynecology (OB/GYN) over a period of seven years with respect to “blood utilization indices” and standard recommendations. Material and methods: Cross-match requisitions from the OB/GYN Department over a period of seven years (2012-2018) were selected and included in the study using a suitable sampling technique. Patient details were retrieved from the Hospital Information System (HIS) database. The preoperative crossmatch requisitions and blood utilization data were recorded. “Blood utilization indices” and whole blood/component utilization patterns were analyzed. Results: A total of 894 units of blood were cross-matched for 523 patients included in the study. A total of 305 of these patients were transfused with 445 units. During the initial phase of the study (2012-2014), the average cross-match-to-transfusion ratio (CTR, 6.6), transfusion probability (12.3), transfusion index (0.23), and component utilization (4%) were in marked deviation from recommended “blood utilization indices.” This was in contrast with the later phase of the study (2015-2018) wherein the average CTR (1.5), transfusion probability (69.3), transfusion index (1.3), and component utilization (91.8%) were compliant with recommended “blood utilization indices.” Conclusion: A progressive improvement in blood utilization practices was observed in the OB/GYN Department during the study period. Awareness campaigns have contributed to the implementation of rational and judicious blood transfusion practices in our center.

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“…It has been reported that elective cesarean sections (c-section) are less risky than vaginal deliveries; however, the orders and crossmatching for blood transfusion for elective procedures can be excessive. 5 , 11 , 12 A study revealed that only a small number of the blood units reserved for elective c-sections are used (0.5%, n=7809). 5 This suggests that blood banks have to provide excessive units for elective c-sections and can be exposed to shortages.…”

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confidence: 99%

Enhancing the utilization of packed red blood cells stock in maternity hospitals

Bawazir

Dakkam

2020

SMJ

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Objectives: To assess and enhance the efficiency of transfusion services in maternity hospitals. Methods: A case control study was conducted from January to December 2016. A corrective policy of replacing preoperative type and hold step with blood transfusion request (BTR) hold was used only on healthy patients undergoing elective cesarean sections (c-section). The crossmatch/transfusion (C:T) ratio and a cost comparison were the evaluating factors. Data were analyzed using an Excel spreadsheet and SPSS statistical software. Results: A total of 1,200 BTRs were analyzed, comprising 659 before implementation of the corrective policy and 541 blood transfusion requests after implementation of the corrective policy. From January to March, the C:T ratio of c-sections was nearly 7 times the American Association of Blood Banks recommended limit of 2.5. Most of the blood units (94%) were damaged due to repeated booking. After implementation, the cost-effectiveness of erythrocyte transfusion was greatly enhanced as all the ordered blood units were used and the C:T ratio was reduced to the ideal limit of one. The number of destroyed units was drastically decreased from 450 units to zero; as a result, 83% of the transfusion costs were saved. Conclusion: The policy enhances the cost-effectiveness of erythrocyte transfusion and laboratory testing, and saves on additional, unnecessary costs.

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A retrospective study of transfusion practice: Blood crossmatch ordering in obstetrics

Cited by 3 publications

References 0 publications

Blood utilization and quality indicators at a university hospital in the Eastern Province of Saudi Arabia

Blood utilization and quality indicators at a university hospital in the Eastern Province of Saudi Arabia

Blood Utilization Trends in Obstetrics and Gynecology: A Seven-Year Retrospective Study in a Teaching Hospital in Sikkim, India

Enhancing the utilization of packed red blood cells stock in maternity hospitals

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