Survey on blood ordering and utilisation patterns in elective urological surgery.
BACKGROUND
Blood transfusion is an important part of the medical care service. As there has not been a regional study about blood requests for operations, this study was done to assess blood ordering for various types of elective urological surgery.


METHODS
In a descriptive, retrospective, cross-sectional study, blood requests for all patients undergoing elective urological surgery in Razi Hospital (Rasht, Iran) during the first 6 months of 2010 were studied. The patients' data (age, sex, weight, type of surgery, haemoglobin level before and after surgery, number of units of blood cross-matched and number of units transfused in the operating theatre and in the 3 days after surgery) were collected from their clinical records. Patients with a history of coagulopathy or anticoagulant drug use were excluded. The cross-match to transfusion ratio (C/T ratio), transfusion index (TI) and transfusion probability (T%) were calculated. The level of statistical significance was set at P =0.05.


RESULTS
Of the 435 patients studied, 327 (75.1%) were male and 108 (24.9%) were female. The mean age of patients was 51.74 ± 19.33 years. The mean number of units of blood requested for each operation was 2.8 ± 1.2, whereas the mean number transfused was 0.59 ± 0.24; the difference was statistically significant (P<0.05). The relationships between pre-operative haemoglobin concentration and both blood requested and blood used were also statistically significant (P =0.038 and P <0.001, respectively). Calculated for all the operations, the C/T ratio was 14.16, the TI was 0.11 and the T% was 8.85%. Overall, only 8.5% of the patients (n=37) need blood transfusion in the operating theatre and only 10.8% (n=47) required transfusion within the 72 hours after surgery.


CONCLUSIONS
The amount of blood requested and cross-matched for elective urological surgery is much greater than the real level of consumption. An appropriate, standard blood order guideline would reduce costs and staff workload.
Urology Research Centre, Guilan University of Medical Sciences, Rasht, Iran.
Hossein
H
Khoshrang
Ali Hamidi
AH
Madani
Zahra Atarkar
ZA
Roshan
Maryam Soltani
MS
Ramezanzadeh
D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D003625:Data Collection; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D013520:Urologic Surgical Procedures