Effectiveness index of preoperative blood preparation for elective neurosurgery at Prasat Neurological Institute
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Abstract
Background: Unnecessary preoperative blood
preparation led to wasting of resources, expired blood
components and increased blood bank workload.
Objective: To evaluate effectiveness index of
preoperative blood preparation for elective surgery at
Prasat Neurological Institute. Method: A retrospective
study was done in elective neurosurgical patients
by reviewing medical records. We evaluated
preoperative blood preparation and intraoperative
blood transfusion until 24 hours postoperatively and
calculated effectiveness indices, i.e., cross-match to
transfusion ratio (C/T ratio), transfusion probability
(%T), and transfusion index (Ti) Results: Data was
analysed in 17 elective surgical procedures in 1,018
patients. Cross-matching were prepared in 964 cases,
for the total of 2,140 units. Only 217 patients required
transfusion and 489 units of blood were used. C/T ratio
was found to be 4.3 %T and Ti were 22 and 0.5,
respectively. Conclusion: The over-ordering of blood
preparation for elective neurosurgery was shown.
Therefore, blood preparation should follow the
Maximal Surgical Blood Order Schedule (MSBOS)
guideline for each operation. The type and screening
blood protocol should be applied for blood preparation
to save cost of patient and hospital, decrease blood blank
workload, decrease unnecessary blood reserves
and improve blood stock management.
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