Asian J Neurosurg. 2018 Apr-Jun;13(2):329-335. doi: 10.4103/ajns.AJNS_104_16.
Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand.
Asian journal of neurosurgery
Ananchanok Saringcarinkul, Siriwan Chuasuwan
Affiliations
Affiliations
- Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
PMID: 29682030
PMCID: PMC5898101 DOI: 10.4103/ajns.AJNS_104_16
Abstract
CONTEXT: Preoperative blood bank testing should optimize the trade-off between intraoperative transfusion delay and blood wastage.
AIMS: This study aims to develop a maximal surgical blood order schedule (MSBOS) for elective neurosurgery.
SETTINGS AND DESIGN: Prospective data in University Teaching Hospital, Northern Thailand.
SUBJECTS AND METHODS: Blood transfusion data were collected on all adult patients satisfying inclusion/exclusion criteria in 2015. Patients were assigned to ten procedure groups (G): vascular: (1) Aneurysm/arteriovenous malformation, (2) Cerebrovascular bypass; tumor resection: (3) Meningioma, (4) Other, (5) Cerebellopontine angle, (6) Pituitary/craniopharyngioma, (7) Endoscopic pituitary; and miscellaneous: (8) Cranioplasty, (9) Spine, (10) Other. The crossmatch-transfusion ratio (C/T), transfusion probability (%T), and transfusion index (Ti) were calculated. MSBOS was generated by applying published criteria, subjected to clinical neurosurgical judgment.
STATISTICAL ANALYSIS USED: Statistical Package for the Social Sciences, Vision 20.
RESULTS: Of 377 patients, 95% underwent preoperative cross-and-match (C and M) testing for 1422 red blood cell (RBC) units, while 3% had no type and screen (T and S) nor C and M, and 2% had T and S only. Overall C/T was 6.6, with range from 4 for G3-53 for G8. Intraoperative %T was 27%. Intraoperative Ti was 0.6. Our MSBOS recommended T and S only for G2, G7, G8, G9, G10; C and M of 2 RBC units for G1, G4, G5, G6; and C and M 2-to-4 for G3. If this were followed in 2015, intraoperative blood needs would have been satisfied for ≥82% of patients, and substantial reductions achieved in blood banking fees.
CONCLUSIONS: Our MSBOS may help optimize blood ordering and serve as an example for similar efforts for other surgical specialties.
Keywords: Blood transfusion; crossmatch-transfusion ratio; elective neurosurgery; maximal surgical blood order schedule; transfusion index; transfusion probability
Conflict of interest statement
There are no conflicts of interest.
References
- Stroke. 2002 Apr;33(4):994-7 - PubMed
- Ann R Coll Surg Engl. 1998 Jul;80(4):262-5 - PubMed
- Neurosurgery. 2001 Nov;49(5):1068-74; discussion 1074-5 - PubMed
- Transfusion. 1977 Mar-Apr;17(2):163-8 - PubMed
- Transfusion. 2008 Oct;48(10):2268-9 - PubMed
- Transfusion. 1976 Jul-Aug;16(4):380-7 - PubMed
- Malays J Pathol. 2002 Jun;24(1):59-66 - PubMed
- West Indian Med J. 2014 Jan;63(1):54-8 - PubMed
- Clin Lab Haematol. 1990;12 (3):321-7 - PubMed
- JAMA. 1980 Apr 18;243(15):1536-8 - PubMed
- Am J Clin Pathol. 1980 Aug;74(2):223-7 - PubMed
- Anesthesiology. 2012 Apr;116(4):768-78 - PubMed
- Transfusion. 1979 May-Jun;19(3):268-78 - PubMed
- Anesthesiology. 2013 Jun;118(6):1286-97 - PubMed
- Acta Neurochir (Wien). 2012 Jul;154(7):1303-8 - PubMed
Publication Types