Is routine preoperative crossmatch appropriate for elective laparoscopic cholecystectomy?
Keywords:
routine cross-matched preoperatively, elective laparoscopic cholecystectomyAbstract
Background : Inappropriate cross-matching results in a costly waste of resources. A 12-month
report from our blood bank demonstrated an inappropriate use of preoperative blood order with the crossmatch to transfusion (C/T) ratio of 2.08.
Objective : The aim of this study was to assess the cost effectiveness of routine preoperative blood order for elective laparoscopic cholecystectomy.The results will be evidence to implement to ourhospital blood order guideline.
Methods: All elective laparoscopic cholecystectomy cases performed in our institution between January and December 2011 were retrospectively reviewed. With the use of electronic databases of our hospital, open cholecystectomy and cholecystectomy secondary to other procedure were excluded. Preoperative blood order and blood transfusion intraoperative and
within 24 hours postoperatively were identified from medical and anesthetic records. Crossmatch to transfusion (C/T) ratio and blood usage parameters (transfusion probability; %T and transfusion index; Ti) were calculated.
Results: A total of 254 patients
were identified. Of these 242 unit of PRC had been ordered (crossmatch) preoperatively for 233 patients (91.7%). Twenty-one patients had no order for blood preparation. Only one unit of PRC was given in 24 hours postoperatively for a thalassemia patient. The total expense for blood preparation was 65,340 Thai baht while the expense for 1 unit given was 270 Thai baht. Crossmatch to transfusion (C/T) ratio was 242; transfusion probability (%T) and transfusion index (Ti) were 0.43 and 0.0041 respectively. Maximal Surgical blood Order Schedule (MSBOS) was 0.062.
Conclusion: This study reveals excessive blood ordering for elective laparoscopic cholecystectomy. Routine crossmatch is not necessary for this type of operation.
Downloads
Published
How to Cite
Issue
Section
License
Copyright
Copyright of all articles published in the Thai Journal of Anesthesiology is held by the Thai Journal of Anesthesiology, the Royal College of Anesthesiologists of Thailand. Submission of a manuscript constitutes the authors' agreement that, upon acceptance for publication, copyright of the work is transferred to the Journal. The content and any opinions expressed in published articles are the sole responsibility of the authors and do not necessarily reflect the views of the editorial board or the Royal College of Anesthesiologists of Thailand.
Licensing
All articles are published open access under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). Under this license, anyone may copy and redistribute published articles in any medium or format for non-commercial purposes, provided that appropriate credit is given to the authors and to the Thai Journal of Anesthesiology as the original source of publication, a link to the license is included, and the material is not modified in any way. Requests for commercial use or for adaptation of published material should be directed to the editorial office.
Authors' Rights
Although copyright is held by the Journal, authors retain the right to reuse their own published material in their future scholarly works, theses and dissertations, teaching, and academic presentations, and to deposit the final published version (PDF) in institutional or subject repositories or on personal and institutional websites, without embargo, provided that the Thai Journal of Anesthesiology is clearly acknowledged as the original place of publication.
