Use of red blood cell transfusions in surgery

• Published in: ANZ journal of surgery Vol. 72; no. 8; pp. 561 - 566
• Main Authors: Maxwell, Ellen L., Metz, Jack, Haeusler, Michael N., Savoia, Helen F.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Pty 01.08.2002
• Subjects: audit; Australia; Blood Banks - standards; Blood Banks - statistics & numerical data; Blood Grouping and Crossmatching - standards; Blood Grouping and Crossmatching - statistics & numerical data; Blood Loss, Surgical - prevention & control; Blood Loss, Surgical - statistics & numerical data; blood transfusion; Blood Transfusion, Autologous - standards; Blood Transfusion, Autologous - statistics & numerical data; Erythrocyte Transfusion - standards; Erythrocyte Transfusion - statistics & numerical data; Humans; maximum surgical blood ordering schedule; Medical Audit - standards; Medical Audit - statistics & numerical data; Practice Patterns, Physicians' - standards; Practice Patterns, Physicians' - statistics & numerical data; Retrospective Studies; surgery; Surgical Procedures, Operative - standards; Surgical Procedures, Operative - statistics & numerical data; Australia
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1046/j.1445-2197.2002.02478.x

Background:  Limited blood supplies necessitate the rational use of blood products. The aim of the present study was to provide a basis for audits of red cell usage in surgery by benchmarking common practice. Application of the data to the construction of a maximum surgical blood order schedule may be relevant for centres that perform a serological crossmatch or who collect autologous units. Methods:  Data on surgical procedures identified by Commonwealth Medical Benefits Schedule item numbers, were collected retro­spectively from theatre and blood bank records at the Royal Melbourne and Melbourne Private hospitals from May 1997 to April 1998. The percentage of procedures for which red cells were transfused, and the mean, median and range of units transfused for procedures with ≥ 30% transfusion likelihood were identified. Results:  Over 12 months, 266 surgical procedure codes were itemized ≥ 10 times each, contributing 12 300 data entries. Only 38 procedures demonstrated an incidence of transfusion of at least 30%. Most frequently transfused procedures included spinal fusion, total hip replacement, mandible/maxilla resection, prostatectomy and bladder excision. Conclusion:  The number of common surgical procedures in which there is a 30% or greater likelihood that red cell transfusions will be given is limited. This benchmarking of common red cell usage is a first step in the process of determination of transfusion appropriateness.