Evaluating Blood Requests and Transfusion Practice in Major Surgical Procedures

Background: Red blood cell and other blood products play a crucial role in management of different disease processes, but in spite of implementation of crucial steps to improve the process of request for blood and blood consumption, there is still not enough information available regarding the proper practice in many medical centres. We aimed to evaluate the status of blood product requests and transfusion practice in surgical patients in Al-Zahra and 17th Shahrivar hospitals, Rasht, Iran. Materials: This retrospective, descriptive cross-sectional study was performed using medical records of patients undergoing major surgical procedures in Al- Zahra and 17th Shahrivar hospitals, Rasht, Iran, from April to December 2013. The cross-match to transfusion ratio (C/T ratio), transfusion probability (T%) and transfusion index (TI) were analyzed. We used SPSS analytical software to analyze the data. Results: Transfusion index was 0.27, transfusion probability 12.8% and C/T ratio was 7.38 which were higher than standards, indicating that only 54 units out of 399 red blood cells units requested were used. Laparoscopic surgery had the worst indicator in terms of wastage of packed cell products. These findings in 17th Shahrivar hospital were 0.09, 8.82% and 12.5, respectively. In this hospital only 10 units out of 125 requested units were used. Appendectomy showed the worst indicators. Conclusion: Blood transfusion indexes particularly for laparoscopic and appendectomy procedures were high in two hospitals studied. In order to overcome this problems, providing teaching courses for proper transfusion practice in surgery departments to improve their knowledge of haemovigilance and preparation of defined guidelines for red blood cells’ cross matching and transfusion is recommended.