Surgical blood order equation in femoral fracture surgery.
OBJECTIVE
This study aimed at establishing the clinical utility of the surgical blood order equation (SBOE) in patients undergoing femoral fracture surgery.


BACKGROUND
A blood ordering schedule defines the perioperative blood use in elective surgery. It lists the number of units of blood required for each procedure preoperatively.


METHODS
A case-control study was performed among homogeneous groups of patients (n = 62 each) undergoing open reduction and internal fixation of femoral fractures. Correct prediction of blood use in the group of patients using the SBOE was compared to the group whose blood orders were made without any guideline.


RESULTS
The surgical blood ordering equation was exactly correct in ordering blood for 46 (74·2%) of 62 patients (cases). The current unaided blood ordering method was exactly correct in ordering blood for 27 (43·5%) of 62 patients (controls). Use of the SBOE resulted in a significantly lower crossmatch-to-transfusion ratio compared to that of the current ordering system (1·5 vs 2·3) and saved the hospital transfusion laboratory 465 US$ of crossmatch and inventory management costs in this cohort of patients.


CONCLUSIONS
The SBOE is a more accurate and cost-saving tool in predicting blood use. It should replace the current unaided method of ordering for perioperative blood in femoral fracture surgery at Mulago Hospital. However, its introduction to other hospitals should be preceded by more rigorous research to strengthen its external validity.
Kajja
I
I
Department of Orthopedics Department of Pathology, Makerere University College of Health Sciences, Kampala, Uganda. kajja133@gmail.com
Bimenya
G S
GS
Eindhoven
G B
GB
ten Duis
H Jan
HJ
Sibinga
C T S
CT
D000328:Adult; D001771:Blood Banks / Q000191:economics; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000191:economics / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D003365:Costs and Cost Analysis; D003658:Decision Making, Computer-Assisted; D005260:Female; D005264:Femoral Fractures / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D055815:Young Adult; D000094902:Blood Banking / Q000379:methods