title: Cross-matched blood in colorectal surgery: a clinical waste?
abstract: OBJECTIVE
  This study was carried out to determine the rate of perioperative blood transfusion and to create an evidence-based approach to requesting blood for elective colorectal surgery.
  
  
  METHODS
  A comparative cohort study was carried out of 164 patients (107 men, 57 women, median age 68 years) who underwent major colorectal surgery. Details obtained included demographic and operative information, the number of units of blood cross-matched, units used, the reasons for transfusion and patient suitability for electronic issue (EI). The cross-match to transfusion ratio (C:T ratio) was calculated for each procedure and for the whole group of colorectal procedures.
  
  
  RESULTS
  Some 162 units of blood were cross-matched for 76 (46%) patients, with the remaining 88 (54%) being grouped with serum saved. Twenty-one (13%) were transfused with a total of 48 units of blood. The C:T ratio for all procedures was 3.4/1. The commonest indication for transfusion was anaemia. One patient required an emergency transfusion. The majority (78%) of patients were suitable for EI. There were no significant differences between the transfused and nontransfused groups with regard to age, diagnosis (malignant vs benign) and laparoscopic or open colorectal procedure.
  
  
  CONCLUSIONS
  Only a small proportion of patients undergoing elective major colorectal surgery require perioperative blood transfusions, most of which are nonurgent. Blood should not be routinely cross-matched in patients who are suitable for EI.
authors.affiliation: Department of Surgery, Southport & Ormskirk Hospital, Southport, Merseyside, UK. hud@doctors.org.uk
authors.forename: H
authors.initials: H
authors.lastname: Shaker
authors.forename: M
authors.initials: M
authors.lastname: Wijesinghe
authors.forename: A
authors.initials: A
authors.lastname: Farooq
authors.forename: D Y
authors.initials: DY
authors.lastname: Artioukh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001788:Blood Grouping and Crossmatching; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D015331:Cohort Studies; D003107:Colorectal Surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019564:Unnecessary Procedures