Survey on blood ordering and utilisation patterns in elective urological surgery

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.

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.

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.

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.