The Crossmatch-to-Transfusion Ratio as a Quality Indicator for Blood Bank Utilization: A Retrospective Analysis

With the rising demand for blood products in India, it is imperative to ensure efficient utilisation of available resources within blood banks. This study aims to assess the crossmatch-to-transfusion (C/T) ratio as a metric for evaluating and optimizing blood utilisation practices. Analysing the C/T ratio across various clinical departments will help identify inefficiencies in blood ordering protocols and support the implementation of corrective strategies to improve overall resource management.

A retrospective observational study was conducted at the Blood Center of Dr. N. D. Desai Medical College & Hospital. Data were collected over one year period from January 2024 to December 2024. The number of cross-matched and transfused data were collected from crossmatch request forms, crossmatch registers, issue registers, and digital medical records. The department wise utilisation of blood and its components C:T ratio were calculated.

During the study period, 5,402 blood units were crossmatched, of which 2,968 units were issued, yielding an overall hospital C:T ratio of 1.43 and an overall utilisation rate of 54.95%. Department-wise analysis showed substantial variation. Obstetrics and Gynaecology recorded the highest C:T ratio (2.83) with a utilisation rate of 35.3%, followed by Orthopaedics (C:T ratio 1.85; utilisation54.1%), General Surgery (C:T ratio 1.57; utilisation63.8%), ENT (C:T ratio 1.32; utilisation75.8%), and General Medicine (C:T ratio 1.14; utilisation87.8%).

The study revealed that the overall crossmatch-to-transfusion (C/T) ratio at the hospital is within internationally accepted standards, with particularly elevated ratios observed in the surgical departments. Developing a standardized blood ordering policy, including guidelines for expected blood usage in surgical and elective procedures, can significantly reduce unnecessary blood orders, avoid redundant compatibility testing, minimize the return of unused units, and prevent wastage due to component expiry-ultimately leading to more efficient blood bank management.