Blood transfusion practices at a level one trauma centre: a one-year retrospective review

Knowledge of blood usage patterns helps to address major issues such as the management of massive transfusion events, minimisation of transfusion risks, as well as in dealing with blood shortages. The aim of our study was to audit blood component usage at a Level I trauma centre blood bank.

A retrospective analysis of the transfusion data of 4,320 patients who were admitted to the General Surgery, Neurosurgery, Orthopaedics and Emergency Medicine departments during a one-year period was conducted.

A total of 4,054 patients underwent transfusion. 88 percent, 94 percent, 80 percent and 100 percent of patients admitted to the General Surgery, Orthopaedics, Neurosurgery and Emergency Medicine departments, respectively, received transfusions. Packed cells were the most commonly utilised component, followed by fresh frozen plasma (FFP) and platelets in the ratio 3:2:1. The highest number of FFPs (2,052 units) and platelet concentrates (950 units) were used in the General Surgery and Neurosurgery departments, respectively. The calculated cross-match to transfusion (C:T) ratio did not exceed 2.5 in any of the departments. Among those transfused, the massive blood transfusion rate was low (1.77 percent). The rates of transfusion reactions and non-group-specific transfusions were also low (0.42 percent and 0.07 percent, respectively).

The rate of transfusion of trauma patients was high (94 percent). Using the C:T ratio as a marker, optimal blood utilisation was noted in all departments. The methods of reporting transfusion reactions need to be revised. Future studies on the appropriateness of blood use and blood ordering schedules are required.