Blood Utilization Review Using Transfusion Indices in a Tertiary Care Center: A Retrospective Observational Study

Background Excessive preoperative blood requisition often results in non-utilization, aging, and wastage of blood units and resources. Transfusion indices help assess the efficiency of the blood requisition process. Hence, this study aimed to analyze blood utilization patterns using transfusion indices across various departments in a tertiary care center. Methodology This study employed a retrospective, observational design, utilizing blood bank records collected over a one-year period from April 1, 2023, to March 31, 2024. A total of 5,881 patients were analyzed. The primary aim was to evaluate blood utilization efficiency by calculating key transfusion indices based on the crossmatching and transfusion of packed red blood cells (PRBCs). These indices included the crossmatch-to-transfusion (C/T) ratio, transfusion probability (TP), and transfusion index (TI). Results Out of 6,694 blood requisitions received during the study period, 5,881 patients underwent PRBC transfusions. A total of 11,894 PRBC units were crossmatched, of which 7,759 (65.23%) units were ultimately transfused. Transfusion indices demonstrated notable variations across different departments. The General Surgery Department recorded the highest C/T ratio at 2.05, while Hemato-oncology and Radiotherapy achieved the highest TP of 96%. In contrast, Dermatology reported the lowest TP at 74%. Gastro-surgery stood out with the highest TI of 2.47. Despite these differences, all departments operated within the established acceptable transfusion thresholds, maintaining C/T ratios below 2.5, TP values above 30%, and TI levels exceeding 0.5. Conclusions Departments with outlier indices should adopt restrictive transfusion practices. Educational programs and department-specific guidelines can optimize blood utilization, reducing unnecessary transfusions, costs, and resource consumption.