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CC BY-NC-ND 4.0 · Asian J Neurosurg 2018; 13(02): 329-335
DOI: 10.4103/ajns.AJNS_104_16
Original Article

Maximum surgical blood order schedule for elective neurosurgery in a University Teaching Hospital in Northern Thailand

Ananchanok Saringcarinkul
Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai
,
Siriwan Chuasuwan
Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai
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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.

Key-words:

Blood transfusion - crossmatch-transfusion ratio - elective neurosurgery - maximal surgical blood order schedule - transfusion index - transfusion probability


Publication History

Article published online:
14 September 2022

© 2018. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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