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A 23 years audit of packed red blood cell consumption in a university hospital in a developing country
Abdel Galil M Abdel Gader1, Abeer K AlGhumlas1, Abdul Karim M Al Momen1
1The Blood Bank, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Insights
This study analyzed packed red blood cell (PRBC) consumption trends over 23 years in a Saudi hospital. Findings reveal overuse of blood products, highlighting the need for improved transfusion practices and adherence to safety guidelines.
Area of Science:
- Transfusion Medicine
- Healthcare Management
- Clinical Audit
Background:
- Limited data exists on blood transfusion practices in developing nations.
- This audit examines long-term trends in packed red blood cell (PRBC) consumption at a major Saudi teaching hospital.
Purpose of the Study:
- To analyze the long-term trend in packed red blood cell (PRBC) consumption.
- To identify patterns and factors influencing PRBC usage across hospital divisions.
Main Methods:
- Annual PRBC consumption data from 1985-2007 were analyzed.
- Data encompassed seven major hospital divisions at King Khalid University Hospital (KKUH), Riyadh.
- Crossmatch:transfusion ratios were assessed to identify over-ordering.
Main Results:
- Total PRBC consumption reached 345,642 units, peaking in 1994.
- Consumption decreased significantly post-1994, influenced by patient expansion and reduced use in Pediatrics and Renal Dialysis.
- High crossmatch:transfusion ratios indicated significant over-ordering and wastage, particularly in Obstetrics and Gynecology.
Conclusions:
- Overuse of blood products was evident, with a notable drop coinciding with global concerns over transfusion safety (e.g., HIV transmission).
- Implementation of strict guidelines is contributing to improved transfusion practices.
- Addressing over-ordering and wastage remains crucial for optimizing blood bank resources.
Background:
There is paucity of information on the blood transfusion practice in developing countries. The current audit aims to find out the long term trend in the consumption of packed red blood cells (PRBCs) in a large Saudi teaching hospital in Riyadh
Materials And Methods:
We analyzed the annual consumption of PRBCs from 1985 to 2007 in seven major hospital divisions (Medicine, General Surgery, Pediatrics, Obstetrics and Gynecology, Cardiac Surgery, Accident and Emergency and Renal Dialysis Unit) at the 850-bed King Khalid University Hospital (KKUH), Riyadh.
Results:
Grand total consumption of PRBCs was 345,642 units. The consumption increased gradually and peaked in the year 1994, dropped to 30.4% 6 years later and then increased gradually thereafter, due to the expansion in the number of patients cared for in the Departments of Medicine, Cardiac Surgery and Accident and Emergency, while in the Department of Pediatrics the drop in consumption continued unabated. In the Renal Dialysis Unit consumption was minimal with the use of erythropoietin therapy. The crossmatch:transfusion ratio uncovered gross over-ordering of PRBCs and wastage of blood bank resources in most hospital divisions most notably in the Department of Obstetrics and Gynecology.
Conclusion:
The results obtained indicate clearly that there has been overuse of blood products that dropped markedly in years coinciding with the worldwide apprehension about the safety of transfusion therapy particularly HIV transmission. This factor in addition to the current implementation of strict guidelines is gradually improving transfusion practices in our institute.
