A prospective randomized trial of the surgical blood order equation for ordering red cells for total hip arthroplasty patients.
BACKGROUND
The majority of crossmatched blood is for surgical patients, and most of it is never transfused. An alternative system for ordering red cell (RBC) units, called the surgical blood order equation (SBOE), which incorporates specific patient variables for surgical patients, has been developed.


METHODS
A prospective double-blind randomized trial compared the SBOE with the maximal surgical blood order schedule (MSBOS) system for ordering allogeneic RBC units in 60 patients undergoing total hip arthroplasty. Autologous RBCs were available for none of the patients.


RESULTS
There were no differences in patient demographic, surgical, or laboratory variables at any time. The median number (range) of allogeneic RBC units ordered was 2 (2-3) for the MSBOS and 0 (0-3) for the SBOE (p<0.0001). The SBOE ordered the correct number of RBC units for 58 percent of patients, while the MSBOS did so for 7 percent (p<0.0001). The SBOE had a lower crossmatch-to-transfusion ratio than the MSBOS (0.83 vs. 4.12). Costs were also lower with the SBOE.


CONCLUSIONS
Incorporation of patient factors in the use of the SBOE system resulted in increased efficiency of blood-ordering practices for total hip arthroplasty.
Nuttall
G A
GA
Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Santrach
P J
PJ
Oliver
W C
WC
Ereth
M H
MH
Horlocker
T T
TT
Cabanela
M E
ME
Trousdale
R T
RT
Bryant
S
S
Currie
T W
TW
D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D001788:Blood Grouping and Crossmatching; D016063:Blood Loss, Surgical; D004311:Double-Blind Method; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D006801:Humans; D011446:Prospective Studies