Optimization of Preoperative Routine Cross-matching for Elective Surgery in Udonthani Cancer Hospital: An Appropriate Use of Resources
Keywords:
Elective surgery, Crossmatch to transfusion, Transfusion probability, Transfusion index, Type and screenAbstract
Background: Blood transfusion is important and appropriate for patients who need surgery but are requiring blood to be prepared for specific medical operations. This could result in the lost cost of blood preparation In addition, the lost opportunity to donate blood to other patients increases the workload at the blood bank. Objective: To study the optimization of preoperative routine cross-matching for elective surgery in Udonthani Cancer Hospital. Method: Data from patients who had had elective surgery was obtained for this retrospective descriptive analysis during a one-year period. Blood preparation for surgery was ordered using routine cross-matching techniques. Furthermore, perioperative and postoperative blood transfusions were ordered within 24 hours. The most appropriate blood order was determined by cross-match to transfusion ratio (C/T ratio), transfusion probability (%T), and transfusion index (Ti). Result: There were 89 patients on elective surgeries who had a total of 172 units prepared, but only 32 patients (35.9%) with 63 units (36.6%) of blood were transfused. The C/T ratio, %T, and Ti were 2.7, 35.9, and 0.7, respectively. The cost of blood preparation for surgery was 49,830 baht, but the actual cost was 33,480 baht. The data were analyzed using the type and screen blood preparation, which was found to save up to 16,350 baht. Conclusion: Elective surgery requires more blood preparation than actual demand, and the information obtained could be used to develop appropriate blood preparation guidelines for surgery to make efficient use of resources.
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