Evaluation of Reservation and Transfusion of PRBCs in Elective Orthopedic, Neurosurgeries and General Surgeries in Madani Hospital

Todays, one of the most common problems in selective surgery is excessive blood ordering and requirement. MSBOS is a program designed to improve the proportion of requests for blood transfusions in selective surgery that has received much attention in recent years.

In a retrospective study,834 records of patients over 18 years of age who underwent 15 elective surgeries at Shahid Madani Hospital in Karaj in 1396 was reviewed and 3 indicators, crossmatch to transfusion ratio (C/T ratio), probability of blood administration (T%) and blood administration index (TI) were extracted.The surgeries were in 3 categories : elective orthopedic surgeries (fracture of femur, humerus, calf, forearm and total knee joint replacement), elective neurosurgeries (lumbar and neck fusion, chronic subdural hematoma and Brain Tumor surgeries) and elective general surgeries (Intestinal resection anastomosis, open cholecystectomy, laparoscopic cholecystectomy , thyroidectomy, bronchoscopy and skin graft in burned patients).

The crossmatched to transfusion ratio (C/T ratio) was 3.97 in all surgeries and less than 2.5 in femoral fracture, chronic subdural hematoma, brain tumor, and skin graft surgeries. In these surgeries the TI index was greater than 0.5 and T% index was more than 30%.

According to the results of this study and similar researches, the preparation of MSBOS (maximum surgical blood ordering schedule) tables as a model for requesting blood can lead to reduction in amount of blood ordering and crossmatch requirement.