ABSTRACT
【Objective】 To establish the maximum surgical blood order schedule(MSBOS) for orthopedic surgery, as to guide the clinical blood application and reasonable blood preparation for this type of surgery. 【Methods】 The ordered and actual amount of transfused blood of orthopedic elective operations in our hospital from 2014 to 2018 were collected by the hospital information(HIS) and blood collection information software of Department of Blood Transfusion.The surgeries were classified and indices, including blood transfusion rate and per capita transfused RBC volume, were calculated, then orthopedic MSBOS was established by combining the surgical transfusion rate, per capita red blood cell infusion volume, the algorithm of MSBOS, the risk of massive hemorrhage and the actual situation of our hospital. 【Results】 A total of 3 730 cases of elective orthopedic surgery were included, and the ordered blood volume was 10 183.8 U. 1084 cases received intraoperative blood transfusion, with the total blood transfusion volume of 3 498.8 U and the blood transfusion rate at 29.1%(1 084/3 730). The blood transfusion volume of surgical patients was [1~17.5(3.21±1.89)] U/patient. MSBOS for orthopedic surgeries had been established in our hospital. According to the blood transfusion data of each surgical procedures, surgical blood ordering was divide into 2 categories: Type/Screen, Type/Screen/Crossmatch (2~8 U). 【Conclusion】 The establishment of MSBOS in Department of Blood Transfusion according to the daily blood use in orthopedic surgery is not only beneficial to guide the blood preparation for orthopedics surgery more scientifically and reasonably, but also can optimize the management of blood inventory and provide reference for the establishment of MSBOS in other blood use departments.
ABSTRACT
BACKGROUND: There have been many efforts to determine maximum surgical blood order schedule (MSBOS) of elective surgery in Korea since 1980?. But most of these data were confined to single hospital, so it was somewhat irrelevant to suggest them as general data in Korea. In this study, we tried to establish MSBOS which can be suggested as substantial and objective data in our country and to increase the efficiency of limited blood products. METHODS: From September 2003 to February 2004, we analyzed average RBC utilization for elective surgery in four university hospitals (Soonchunhyang University Hospital, Soonchunhyang University Bucheon Hospital, Korea University Ansan Hospital, Ajou University Hospital) by referring to anesthesiologic records and blood delivery sheets. Also, we established MSBOS range in operations performed more than five times in three among four hospitals. RESULTS: Sixty-seven operations were analyzed in our study and 18 of them were performed in department of general surgery. Type and screen (T&S) was recommended in 69.8~83.6% and the percentage of operations recommended as T&S in all four hospitals was 52.2%. Operations of obstetric/gynecology, urology and otorhinolaryngology were mostly applicable to T&S. CONCLUSION: We suggested comprehensive and substantial MSBOS range by analyzing the operations performed in four hospitals whose operation numbers ranged from 470 to 1,200 per month. It was considered that MSBOS range, which could be applicable to various hospitals, should be reestablished and enforced regularly to decrease medical cost and improve blood utility