A Survey on Transfusion Status in Orthopedic Surgery at a Trauma Center

  Background: Increased costs and mortality associated with inappropriate blood transfusions have led to investigations about blood request and blood transfusion techniques. We investigated the transfusion status in patients who underwent orthopedic surgery in Poursina Hospital (Rasht, Iran) to optimizing blood usage and determine if a scheduled transfusion program for every orthopedic surgery could improve blood transfusion management. Method: In this descriptive-prospective study, all orthopedic surgeries in Poursina Hospital, Rasht, between April to June ۲۰۱۳ were reviewed. All patient information was recorded, including: demographics, type of surgery, hemoglobin level, cross-match test, duration of surgery, and blood loss, and transfusion. Based on the one-way ANOVA and independent samples test analysis, cross-match to transfusion ratio and transfusion possibility, the transfusion index, and maximal surgical blood order schedule were calculated to determine blood transfusion status. Results: Among ۸۷۲ selected orthopedic surgery candidates, ۳۱۸ of them were cross-matched and among those, ۱۱۴ patients received a blood transfusion. In this study, the cross-match to transfusion ratio was ۶.۴, transfusion possibility ۳۶.۴۷%, transfusion index ۰.۶, and maximal surgical blood order schedule ۰.۹. Conclusion: We found that blood ordering was moderately higher than the standard; so it is highly recommended to focus on the knowledge of evidence based on transfusion and standard guidelines for blood transfusion to avoid over-ordering.

Keywords:

Blood transfusion , Orthopedic surgery , Transfusion index , Transfusion possibility