Efficiency of Blood Utilization in Elective Surgical Patients and Associated Factors in Addis Ababa, Ethiopia from November 2023 to April 2024.
| dc.contributor.advisor | Tilahun Rahel | |
| dc.contributor.advisor | Berhanu Tseganesh | |
| dc.contributor.author | Demsie Yidersal | |
| dc.date.accessioned | 2025-08-12T20:12:33Z | |
| dc.date.available | 2025-08-12T20:12:33Z | |
| dc.date.issued | 2024-05 | |
| dc.description.abstract | Background: Blood transfusion is vital for managing patients with significant blood loss preoperatively.However, over-ordering of blood is prevalent, resulting in increased costs and resource wastage. Implementing various transfusion indices can help reduce unnecessary blood requests for elective surgical patients without compromising patient care. Objective: To assess the efficiency of blood utilization in elective surgeries and associated factors at different hospitals in Addis Ababa from November 1, 2023, to April 30, 2024. Methods: A multi-center cross-sectional analytical study was conducted over a period of six months from November 1, 2023, to April 30, 2024, at TASH, MH, GMH, and LGH. Using sequential sampling and a structured checklist, data were collected from all elective surgical patients during this period. Collected data were coded, entered into a Google form and Excel, and analyzed using SPSS version 26. Blood utilization was assessed using various parameters including cross-match to transfusion ratio (C/T), transfusion probability (%T),transfusion index (TI), and Maximum Surgical Blood Ordering Schedule (MSBOS) based on Mead's criterion for common surgical procedures. Bivariate binary logistic regression analyses were employed to identify independent predictors of intraoperative blood transfusion, with odds ratios and 95% confidence intervals estimated for each predictor. Statistical significance was considered at a p-value ≤ 0.05. Results: A total of 574 elective surgical patients (30% from TASH, 26% from MH, 22% from GMH, and 22% from LGH) participated in the study; with 22% (126 patients) receiving intraoperative blood transfusions. From all, 469(81.7%) had blood requested and prepared. The cross-match to transfusion ratio (C/T) was 4.5(C/T<2.5is indicative of efficient blood usage), with a transfusion probability (%T) of 26.8% (%T>30% is considered efficient blood usage), and a transfusion index (TI) of 0.39(TI>0.5 is considered efficient blood usage), leading to a Maximal Surgical Blood Order Schedule (MSBOS) of 0.59.Independent predictors of intraoperative blood transfusion that we get from this study include ASA class III and above (p=0.000), ASA class II(p=0.018), Patient Transfused Preoperatively (p=0.000), Intraoperative blood x loss > 15% (p=0.000), Duration of surgery greater than three hours (p=0.017), Type of Anesthesia (General Anesthesia) (p=0.002), of the study groups. Conclusion and Recommendations:In this study, we observed that there is a concerning disparity between the quantity of blood requested and cross-matched for elective surgery patients and the actual amount utilized. This excessive cross-matching results in resource wastage, heightened workload, and increased financial burden. Moreover, it poses potential challenges to the blood supply, prompting a need to revise our blood requisition protocols. To optimize blood utilization, we recommend revising the current blood ordering pattern and minimizing over-ordering. This can be achieved by implementing an updated Maximum Surgical Blood Order Schedule (MSBOS) tailored to our institution, alongside an emergency blood-releasing system. Utilizing parameters such as Crossmatch-to-Transfusion (C/T) ratio and Transfusion Index (TI) can guide the development of the MSBOS, with consideration for a Group Save and Hold (GSH) for procedures with low TI values. Regular surveillance of utilization patterns and feedback mechanisms are essential for continuous improvement in transfusion practices | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/6530 | |
| dc.language.iso | en_US | |
| dc.publisher | Addis Ababa University | |
| dc.subject | Blood transfusion | |
| dc.subject | Elective Surgeries | |
| dc.title | Efficiency of Blood Utilization in Elective Surgical Patients and Associated Factors in Addis Ababa, Ethiopia from November 2023 to April 2024. | |
| dc.type | Thesis |