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Reviewing the blood ordering schedule for elective orthopedic surgeries at a level one trauma care center
BACKGROUND: Patients undergoing elective orthopedic surgeries often incur excess blood loss necessitating transfusion. The preoperative placement of blood requests frequently overshoots the actual need resulting in unnecessary crossmatching. AIMS: Our primary goal was to audit the blood utilization...
Autores principales: | , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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Medknow Publications
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938486/ https://www.ncbi.nlm.nih.gov/pubmed/20930965 http://dx.doi.org/10.4103/0974-2700.66521 |
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author | Subramanian, Arulselvi Rangarajan, Kanchana Kumar, Sudeep Sharma, Vijay Farooque, Kamran Misra, Mahesh Chandra |
author_facet | Subramanian, Arulselvi Rangarajan, Kanchana Kumar, Sudeep Sharma, Vijay Farooque, Kamran Misra, Mahesh Chandra |
author_sort | Subramanian, Arulselvi |
collection | PubMed |
description | BACKGROUND: Patients undergoing elective orthopedic surgeries often incur excess blood loss necessitating transfusion. The preoperative placement of blood requests frequently overshoots the actual need resulting in unnecessary crossmatching. AIMS: Our primary goal was to audit the blood utilization in elective orthopedic surgeries in our hospital over a 1-year period and recommend a blood ordering schedule. MATERIALS AND METHODS: A retrospective analysis of patients who underwent elective orthopedic surgeries over a period of 1 year was done. The data collected include patients’ age, sex, type of surgical procedure, pre- and postoperative hemoglobin (Hb) levels, number of units crossmatched, returned, transfused, crossmatch to transfusion ratio (C:T), transfusion indices, estimated blood loss for each surgical procedure, and the actual and predicted fall in Hb. We propose a blood ordering schedule based on surgical blood ordering equation. RESULTS AND CONCLUSIONS: A total of 487 patients with a median age of 37±17 years (mean ± standard deviation) were evaluated. One thousand three hundred and seventy-seven units of blood were crossmatched and only 564 units were transfused to 260 patients. Fifty-nine percent of the units crossmatched were not transfused. Six of the 12 elective procedures had a C:T ratio higher than 2.5. Ten of the 12 procedures (83.3%) had a low transfusion index (TI < 0.5). The calculated red blood cell units were less than 0.5 in 5 of the 12 elective procedures, and hence we recommend a group and save policy for these procedures. Blood ordering schedule based on patient and surgical variables would provide an efficient way of blood utilization and management of resources. |
format | Text |
id | pubmed-2938486 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Medknow Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-29384862010-10-07 Reviewing the blood ordering schedule for elective orthopedic surgeries at a level one trauma care center Subramanian, Arulselvi Rangarajan, Kanchana Kumar, Sudeep Sharma, Vijay Farooque, Kamran Misra, Mahesh Chandra J Emerg Trauma Shock Original Article BACKGROUND: Patients undergoing elective orthopedic surgeries often incur excess blood loss necessitating transfusion. The preoperative placement of blood requests frequently overshoots the actual need resulting in unnecessary crossmatching. AIMS: Our primary goal was to audit the blood utilization in elective orthopedic surgeries in our hospital over a 1-year period and recommend a blood ordering schedule. MATERIALS AND METHODS: A retrospective analysis of patients who underwent elective orthopedic surgeries over a period of 1 year was done. The data collected include patients’ age, sex, type of surgical procedure, pre- and postoperative hemoglobin (Hb) levels, number of units crossmatched, returned, transfused, crossmatch to transfusion ratio (C:T), transfusion indices, estimated blood loss for each surgical procedure, and the actual and predicted fall in Hb. We propose a blood ordering schedule based on surgical blood ordering equation. RESULTS AND CONCLUSIONS: A total of 487 patients with a median age of 37±17 years (mean ± standard deviation) were evaluated. One thousand three hundred and seventy-seven units of blood were crossmatched and only 564 units were transfused to 260 patients. Fifty-nine percent of the units crossmatched were not transfused. Six of the 12 elective procedures had a C:T ratio higher than 2.5. Ten of the 12 procedures (83.3%) had a low transfusion index (TI < 0.5). The calculated red blood cell units were less than 0.5 in 5 of the 12 elective procedures, and hence we recommend a group and save policy for these procedures. Blood ordering schedule based on patient and surgical variables would provide an efficient way of blood utilization and management of resources. Medknow Publications 2010 /pmc/articles/PMC2938486/ /pubmed/20930965 http://dx.doi.org/10.4103/0974-2700.66521 Text en © Journal of Emergencies, Trauma, and Shock http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Subramanian, Arulselvi Rangarajan, Kanchana Kumar, Sudeep Sharma, Vijay Farooque, Kamran Misra, Mahesh Chandra Reviewing the blood ordering schedule for elective orthopedic surgeries at a level one trauma care center |
title | Reviewing the blood ordering schedule for elective orthopedic surgeries at a level one trauma care center |
title_full | Reviewing the blood ordering schedule for elective orthopedic surgeries at a level one trauma care center |
title_fullStr | Reviewing the blood ordering schedule for elective orthopedic surgeries at a level one trauma care center |
title_full_unstemmed | Reviewing the blood ordering schedule for elective orthopedic surgeries at a level one trauma care center |
title_short | Reviewing the blood ordering schedule for elective orthopedic surgeries at a level one trauma care center |
title_sort | reviewing the blood ordering schedule for elective orthopedic surgeries at a level one trauma care center |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938486/ https://www.ncbi.nlm.nih.gov/pubmed/20930965 http://dx.doi.org/10.4103/0974-2700.66521 |
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