Establishment of a Maximum Surgical Blood Order Schedule and Red Blood Cell Mean Transfusion Units Per Patient According to Adjacent Diagnosis Related Groups Patient Classification System

ABSTRACT

Background@#For effective management of blood components, periodic updates of the maximum surgical blood order schedule (MSBOS) using recent data are crucial. This study aimed to establish an updated MSBOS and red blood cell (RBC) mean transfusion units per patient according to the adjacent diagnosis related groups (ADRG) classification system. @*Methods@#This retrospective study was based on an audit of the medical records of inpatients at a tertiary hospital between January and December 2017. We investigated transfusion-related data to establish the MSBOS and determine the RBC mean transfusion units per patient according to the ADRG and compared these updated values with previous data. @*Results@#During the investigated period, a total of 5,607 RBC units were transfused in 17,382 patients. The revised MSBOS was similar to the previous MSBOS in most surgeries. Among the 130 ADRG codes analyzed, 34 codes showed an increase, while 96 codes showed a decrease in RBC mean transfusion units per patient, compared to data from 2007. Overall, the RBC mean transfusion units per patient in 2017 was 0.89 units less compared to that in 2007 after adjusting for age (95% CI 0.853–0.912). @*Conclusions@#The revised MSBOS was similar to that of the previous versions. However, there were differences in the number of RBC transfusion units used in some surgeries and disease treatments compared to those in the past. Considering the changes within the medical environment, this study highlights the importance of periodic evaluation of MSBOS and RBC transfusion usage.