Assessment of Blood Requisition, Transfusion Practices and Factors Associated with Transfusion in Elective Surgical Procedures at Tikur Anbessa Specialized Hospital, from February 1, 2016 To March 31, 2016 Addis Ababa, Ethiopia
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Date
2016-06
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Addis Abeba University
Abstract
Background: For elective surgeries preoperative over ordering of blood is very common
practice and leads to holding up of the blood bank reserve, ageing of the blood unit and wastage
of blood bank resources. That can be decreased by simple means of changing the blood cross
matching and ordering schedule depending upon the type of surgery performed.
Objectives: To assess blood requisition, transfusion practices and factors associated with
transfusion in elective surgical proceduresat TikurAnbessa specialized HospitalfromFebruary 1
to March 31, 2016 G.C.
Methods:An Institution based cross sectional study was conducted from February 1, 2016 to
March 31, 2016 G.C at Tikur Anbessa specialized Hospital. Using sequential sampling technique
and structured checklist data was collected from all elective surgical patients that came during
the 2 months period. Blood utilization was calculated using cross match to transfusion ratio
(C/T), transfusion probability (%T), transfusion index (TI) and Maximum surgical blood-
ordering schedule (MSBOS) is formulated by Mead's criterion for common surgical procedures.
Multivariate logistic regression analysis was conducted to identify significant predictors of
transfusion based on p-value less than 0.05 with 95% confidence level.
Results: Among all 242 elective surgical patients 55 (22.7%) of patients were transfused with
107(20.4%) units of the prepared blood giving cross-match to transfusion ratio of 4.9,transfusion
probability (%T) 22.7% and transfusion index of 0.44. The independent predictors of
perioperative blood transfusion were being neurosurgery (craniotomy) [AOR= 5.868 (95%CI
1.364, 25.239)] (P=0.017), Hgb <11.0 g/dl [AOR=7.553 (95%CI 2.915, 19.576)] (p =0.00) and
intraoperative blood loss of >15 %( [AOR=12.830, (95% CI, 5.613, 29.323)] (P = .000).
Conclusion and Recommendation: The amount of blood requested and cross-matched for
patients undergoing elective surgery is much greater than the amount actually used. So blood
ordering pattern needs to be revised and over ordering of blood should be minimized. This can
be possible by implementing an updated, institution-specific MSBOS along with an Emergency
Blood Releasing system.
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Keywords
Blood Requisition; Tikur Anbessa Specialized Hospital