Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand
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...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898101/ https://www.ncbi.nlm.nih.gov/pubmed/29682030 http://dx.doi.org/10.4103/ajns.AJNS_104_16 |
_version_ | 1783314073536954368 |
---|---|
author | Saringcarinkul, Ananchanok Chuasuwan, Siriwan |
author_facet | Saringcarinkul, Ananchanok Chuasuwan, Siriwan |
author_sort | Saringcarinkul, Ananchanok |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5898101 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-58981012018-04-20 Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand Saringcarinkul, Ananchanok Chuasuwan, Siriwan Asian J Neurosurg Original Article 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. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5898101/ /pubmed/29682030 http://dx.doi.org/10.4103/ajns.AJNS_104_16 Text en Copyright: © 2018 Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Saringcarinkul, Ananchanok Chuasuwan, Siriwan Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand |
title | Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand |
title_full | Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand |
title_fullStr | Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand |
title_full_unstemmed | Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand |
title_short | Maximum Surgical Blood Order Schedule for Elective Neurosurgery in a University Teaching Hospital in Northern Thailand |
title_sort | maximum surgical blood order schedule for elective neurosurgery in a university teaching hospital in northern thailand |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5898101/ https://www.ncbi.nlm.nih.gov/pubmed/29682030 http://dx.doi.org/10.4103/ajns.AJNS_104_16 |
work_keys_str_mv | AT saringcarinkulananchanok maximumsurgicalbloodorderscheduleforelectiveneurosurgeryinauniversityteachinghospitalinnorthernthailand AT chuasuwansiriwan maximumsurgicalbloodorderscheduleforelectiveneurosurgeryinauniversityteachinghospitalinnorthernthailand |