Estimation of Blood Utilization in Elective Surgeries to Formulate Maximum Surgical Blood Ordering Schedule for a Tertiary Care Center in North India

• Published in: International journal of applied and basic medical research Vol. 15; no. 3; pp. 163 - 170
• Main Authors: Kalra, Tamanna, Gupta, Saurabh, Gupta, Anshul, Bansal, Nidhi, Kaur, Yadwinder, Kajal, Shiny
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow 01.07.2025; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd
• Edition: 2
• Subjects: Blood transfusion; Blood transfusions; Children; Elective surgery; Original Article; Otolaryngology; Surgery; India; Blood utilization; transfusion index; maximum surgical blood ordering schedule; cross-match to transfusion ratio; transfusion probability
• ISSN: 2229-516X; 2248-9606
• DOI: 10.4103/ijabmr.ijabmr_89_25

Background: Blood transfusion has an essential role in the resuscitation and management of patients undergoing surgical procedures. However, instances of incongruous blood ordering and usage have been reported worldwide, requiring an assessment of blood ordering patterns and addressing the gaps between requisition and utilization through programs such as Maximum Surgical Blood Ordering Schedule (MSBOS). Aim: To estimate blood utilization, design a blood ordering schedule as a guide to normal transfusion needs for common elective surgeries and analyze the specialty-wise difference in blood transfusion indices. Methods: An observational and cross-sectional study was undertaken for 12 months. Fifty-two elective surgeries across eight different surgical specialties were analyzed, including Urology, Cardiothoracic Surgery, Gastrosurgery, Pediatric Surgery, Oncosurgery, Orthopedics, Obstetrics and Gynecology, and Otorhinolaryngology. Blood utilization indices - Cross-match to Transfusion Ratio (CTR), transfusion probability (%T), Transfusion Index, Blood Utilization%, NonUsage Probability, and Blood Ordering Quotient (BOQ) were calculated against standard blood usage to formulate the MSBOS using the Mead's criteria. Results: For 882 patients, 1160 packed red blood cells units were requested and cross-matched. Five hundred and seventy-four units were transfused. The nonutilization of 586 units (51%) suggested an indiscriminate ordering of blood. The nonusage of units cross-matched ranged from 27% to 100% in different specialties. The overall %T was 48.64%, varying from 13.23% in urological surgeries to 88.89% in cardiothoracic surgeries. The CTR ranged from 1.37 to 7.38, TI from 0 to 2.03, and BOQ from 0.92 to 1.36 in different specialties. Conclusion: Rationalizing blood usage is essential. Developing an MSBOS based on the findings would enhance the efficiency of blood utilization in elective surgeries.