Preoperative Predictors of Peri-operative Red Blood Cell Transfusion in Major Pediatric Surgical Procedures

Authors

  • Hasun Muhamad Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hadyai, Songkla 901 10, Thailand.
  • Surasak Sangkhathat Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hadyai, Songkla 901 10, Thailand.
  • Alan Geater Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hadyai, Songkla 901 10, Thailand.
  • Worapong Chawchoowej Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hadyai, Songkla 901 10, Thailand.
  • Sakda Patrapinyokul Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hadyai, Songkla 901 10, Thailand.

Abstract

Background: Unnecessary pre-operative request of blood cross-matching causes unnecessary medical expenses. To reduce the "cross-matching" to "transfuse" ratio needs data regarding the actual use of blood in certain group of patients.

Objective: To determine the preoperative predictors of peri-operative red blood cell transfusion in major pediatric surgical procedure. The data will be valuable in establishing practice guideline for blood request in our service.

Materials and Methods: Medical records of pediatric patients aged 0-14 years who underwent elective major surgery in the pediatric surgical service, Songklanagarind hospital from May 1996 to June 2001 were reviewed regarding preoperative clinical and hematologic status, type of operation, blood request and blood transfusion. Univariate exploration for crude association was done, using Pearson Chi squared test. Multivariate analysis employed the logistic regression models and stepwise exclusion. Statistical significance was set at p-value less than 0.05.

Results: There were 366 patients (operations) included in the analysis. Blood were requested for 334 cases whereas 115 cases (34.4%) received transfusion. Univariate exploration showed possible associations (P<0.2) of red blood cell transfusion with associated pulmonary disease, associated renal disease, diagnosis, type of operation, AS A score, operative time and estimated blood loss. The multivariate analysis finally revealed preoperative hemoglobin level and type of operation as the only significant preoperative predictors for red blood cell transfusion (p<0.05).

Conclusions: Multivariate analysis of various factors associated in the red blood cell transfusion practice in a pediatric surgical service was done. Type of operation and pre-operative hemoglobin level were found to be the key transfusion predictors.

References

1. Annual Statistics from the Blood Bank Unit, Department of Pathology, Songklanagarind Hospital; 2001.

2. Tyler VV. Blood utilization management, In: Tyler VV, editor. Technical Manual of the Committee of the American Association of Blood Banks. 13th ed. Bethesda: American Association of Blood Banks; 1999. p. 81-2.

3. Sudhindran S. Perioperative blood transfusion: a plea for guidelines. Ann R Coll Surg Engl 1997;79: 299-302.

4. Carson JL, Duff A, Berlin JA, et al. Perioperative blood transfusion and post-operative mortality. JAMA 1998; 279:199-205.

5. Carson JL, Willett LR, Is a hemoglobin of 10 g/dl required for surgery? Med Clin North Am 1993; 77: 335-43.

6. Audet A, Goodnough LT. Practice strategies for elective red blood cell transfusion. Ann Intern Med 1992; 116:403-6.

7. Stehling LC, Arizona s, Doherty DC, et al. Practice guidelines for blood component therapy; a report by the American Society of Anesthesiologists task force on blood component therapy. Anesthesiology 1996; 84: 732-7.

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Published

2004-06-30

How to Cite

1.
Muhamad H, Sangkhathat S, Geater A, Chawchoowej W, Patrapinyokul S. Preoperative Predictors of Peri-operative Red Blood Cell Transfusion in Major Pediatric Surgical Procedures. Thai J Surg [Internet]. 2004 Jun. 30 [cited 2024 Nov. 23];25(2):67-70. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/242840

Issue

Vol. 25 No. 2 (2004): April - June

Section

Original Articles

License

Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.