Original article / research
Blood Utilisation Practices and Quality Indicators at a Tertiary Care Hospital in South Delhi-A Retrospective Study
Dr. Zeeba Jairajpuri,
Department of Pathology, Hamdard Institute of Medical Sciences and Research, First Floor, New Delhi-110062, India.
Introduction: Blood transfusion services have an essential role in the resuscitation and management of patients undergoing elective surgeries and are an integral part of the healthcare system all over the world. Crossmatch to Transfusion Ratio (C:T) is an important national quality indicator used to estimate the appropriate use of services offered by the transfusion laboratory.
Aim: To assess blood utilisation practices by analysing Cross Match to Transfusion Ratio (C:T).
Materials and Methods: A seven years retrospective and cross-sectional study was carried out in a tertiary teaching hospital located in South Delhi catering to low socioeconomic population; study was conducted in the Blood bank of Department of Pathology from January 2012 to December 2018. The department wise utilisation of blood and its components C:T ratio, Transfusion probability (T%) and index (TI) were calculated.
Results: Out of the 3952 units prepared, 2850 (72.1%) units were transfused and rest 1102 (27.8%) were prepared but not transfused. Thus, only 72.1% of total blood cross matched was utilised, leaving 27.8% of the units cross matched but not transfused to the patient. Department of medicine had the highest number of patients cross matched, 1297 (32.8%), as well as with number of units transfused 1122 (86.5%) with only 175 (13.5%) units left non-transfused. Obstetrics and Gynaecology department had second highest number of patients cross matched 1137 (28.7%) with number of transfused units being 545 (48%) and 592 (52%) non-transfused. In present study, the overall C:T ratio was 1.4. The T% and TI values obtained were 68.3% and 1.2 respectively.
Conclusion: The overall ratio of C:T, T%, and TI index are considered to be optimal as compared with the standard values though majority of the cross matched blood was not utilised. Developing a blood ordering policy, a guide to normal blood usage for surgical and other elective procedures, can reduce extra ordering of blood, unnecessary compatibility testing, returning of unused blood, and wastage due to expiry of components, allowing a more efficient management.
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