title: An audit on the blood transfusion requirements for revision hip arthroplasty.
abstract: The hospital transfusion committee of Swindon and Marlborough NHS Trust had formulated a maximum surgical blood ordering schedule (MSBOS) which included the standard practice of 6 units of blood for revision hip arthroplasty. A retrospective audit of 73 patients who underwent revision hip arthroplasty over a year was undertaken to identify current practice and to ensure that the standard was adequate for patient safety. Information regarding the number of units requested, number of units transfused, pre-operative haemoglobin (Hb), lowest postoperative Hb and number of additional units of blood requested within 3 days postoperatively, was collected from patients' case-notes. Of the 73 patients, 80.3% received less than 6 units, 12.2% received 6 units and 7.5% received more than 6 units. Based on pre-operative Hb, blood usage was analysed. Of cross-matched units, 92.3% were used when pre-operative Hb was < 12 g/dl, 64.4% were used when Hb was between 12.1-13.0 g/dl, 54.3% were used when the Hb was between 13.1-14.0 g/dl, 38.9% were used when Hb was between 14.1-15.0 g/dl and 39.7% used with pre-operative Hb of > 15.0 g/dl. Of the total, 14 patients had a postoperative Hb of < 9 g/dl for whom additional units of blood were ordered and given to achieve a Hb of between 10.1-14.2 g/dl prior to discharge. This audit suggests that in patients with pre-operative Hb of 13 g/dl or more, the cross-match could be 4 units instead of 6 units for revisions.
authors.affiliation: Departments of Orthopaedics and Audit, Princess Margaret Hospital, Swindon, UK.
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.forename: H
authors.initials: H
authors.lastname: Cooper
authors.forename: J P
authors.initials: JP
authors.lastname: Ivory
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D004739:England; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008485:Medical Audit; D011182:Postoperative Care / Q000706:statistics & numerical data; D011300:Preoperative Care / Q000706:statistics & numerical data; D012086:Reoperation; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins