1240
Views & Citations240
Likes & Shares
Aim: To evaluate the
cross-match/transfusion (C/T) ratio, which is a new indicator used in blood
transfusion centers, in terms of different clinics in our institution.
Methods: The
number of cross-matches and transfusions performed in our Blood Transfusion Center
during the nine-month period between April 2018 and December 2018 were obtained
from Hospital Information Management. A ratio of 1.2 and below is considered
indicative of optimum blood usage.
Results: During
the 9-month study period 9407 crossmatches and 8691 transfusions were performed
included in the study was and the total number of was. The C/T ratio of our
hospital in the study period was found to be 1.08 x 100. The best C/T ratios
were seen in Departments of Cardiovascular Surgery and Plastic Reconstructive
and Aesthetic Surgery. The worst ratio was 1.67 which was detected in
Department of Chest Surgery, followed by 1.37 which was detected in Department
of Infectious Diseases and Clinical Microbiology.
Conclusions: It can be stated that, the C/T
ratios in our hospital have reached the international standards of blood
centers.
Keywords: Cross-match, Transfusion, Blood center
INTRODUCTION
Blood transfusion is needed in chronic diseases such as accidents, wars
and disasters, various criminal attempts, surgical interventions, hemophilia,
leukemia, aplastic anemia, and serious clinical conditions such as pregnancy
where any other therapeutic option is not available [1]. Individuals who make
up the society need blood and blood products from time to time for themselves,
their families or their immediate surroundings for various reasons throughout
their life. Since blood and blood products cannot be obtained under laboratory
conditions, vitally important blood should be obtained from healthy individuals
[2]. The annual blood need of a country is about 1 million units per year [3].
It should be remembered that 5% of the society donates voluntary blood to meet
this rate in developed countries. In our country, the blood donation rate is at
the level of 1.5% of the society [4]. It is clear that with this rate, the need
for blood cannot be met. Keeping this shortcoming in mind, unnecessary blood
demand should be avoided.
Unnecessary blood request is an event that crucially affects the stock
in the blood centers. As a result of each unnecessary request, the blood
component prepared by cross-match loses a certain time from its shelf life [5].
In the effective operability of blood centers, the ratio of the amount of
cross-match product to the transfused is important. This rate is the best
indicator of proper blood use for the hospital and the communication between
the clinician and the blood center. Quality Indicators of Transfusion Centers
were revised in April 2018 and “evaluation of cross-match / transfusion (C/T) ratio”
came into force [6].
In this study, it is aimed to evaluate the C/T ratio, which is a new
indicator used in blood transfusion centers, in terms of different clinics in
our institution, and to make necessary improvements regarding the use of
erythrocyte suspension in our hospital by examining our data.
METHODS
In this study, the number of crossmatches and transfusions performed in S.B.Ü. Bozyaka Training and Research Hospital Blood Transfusion Center during the nine-month period between April 2018 and December 2018 were obtained from Hospital Information Management System.
The C/T ratio in the relevant period for every department was computed
using the following equation:
[Crossmatch to transfusion ratio = Number of unit’s cross-matched /
number of units transfused]
A ratio of 1.2 and below is considered indicative of optimum blood
usage.
RESULTS
During the 9-month study period 9407 crossmatches, and 8691
transfusions were performed included in the study wasand the total number of
was. The C / T ratio of our hospital in the studyperiod was found to be 1.08 x
100. This ratio complies with the <2 standard, which is an indicator of
effective functioning of blood centers.
DISCUSSION
The aim of this study is to evaluate the C/T ratio, which is a new
indicator used in blood transfusion centers, in different clinics in our
institution. When the C/T ratios in our hospital are evaluated, it is seen that
our institution has reached the international standards of blood centers.
Blood shortage is a major problem for most blood banks in our country
because of a great demand and a poor donation culture. In our country, the need
for blood is largely provided by relatives of patients, and the amount of blood
donated by voluntary citizens remains at quite a low level. The San GUIS study,
which compared 43 training hospitals in terms of transfusion approaches in ten
European Union countries, is one of the important studies that question blood
transfusion. In this study, it has been stated that blood transfusion rates
vary highly between hospitals in standard operations and homogeneous patient
groups. For example, in coronary artery bypass grafting operations, this rate
was found to be between 0-96% and in total hip prosthesis between 0 and 100 %,
while it showed that blood was not used in some centers for the same operation
in patients with similar clinical features, while blood was almost always used
in other centers [7]. This condition was interpreted as, “Blood transfusion is
an application that takes place according to the request of a physician, not to
the need of a patient” [8]. Today, the ratio between the cross-matched and
transfused blood or blood products is important in evaluating the working
performance of blood centers. The C/T ratio is the total number of unit’s
cross-matched in advance of surgery units divided by the total units actually
transfused. According to international standards of blood centers C/T ratio is
desired to be <2 [6]. There are many benefits of determining the C/T ratio
according to different departments within the institution. First of all, the
distribution of unused blood albeit prepared for the patients among physicians
and services is monitored. Secondly, in-service training can be given to
physicians and services with a high C/T ratio. Although blood products within
the hospital can reach the required place within 30 min in blood transport
containers, blood products that are not used out of necessity can lead to
product losses. Since reservations are made in the name of the patient in the
blood center, the clinicians are responsible for informing the blood center if
the blood need for the patient has disappeared [5]. The good functioning of the
communication processes, even if protocols are created, still depends on the
discretion of human beings.
When deciding on a transfusion, it is absolutely necessary to review
whether the patient really needs transfusion, which blood product is needed,
and how many units of blood should be transfused to the patient. In the study comparing 3 major hospitals
abroad, the withdrawal rate of blood requirement was found to be 4%, 15% and
25%, respectively, and the corresponding C/T ratios were 1.3, 2, 2.2 [9]. While
the C/T ratios in Erciyes University blood bank were 2.5 before 2005, this rate
decreased to 1.4 with the encouragement of giving up unnecessary blood use in
hospitals in 2007 [10].
The reasons for achieving the target values of our hospital may be
listed as the periodic trainings organized by the Hemovigilance Unit regarding
the blood transfusion center being close to the clinics where transfusion is
performed, compliance with critical blood stock policies, communication with
clinics and transfusion indications.
CONCLUSION
When the C/T ratios in our hospital are
evaluated, it is seen that our institution has reached the international
standards of blood centers. Since any unnecessary cross-match tests were not
performed in our hospital, an advantage in terms of cost and personnel
functionality has been gained.
FUNDING STATEMENT
No financial support or funding was received for this paper.
CONFLICT OF INTERESTS
Authors declare that there is no conflict of interest in this article
1. The
Lancet Haematology (2016) Updates on blood transfusion guidelines. Lancet
Haematol 3: e547.
2. Lockwood
G (2018) Blood transfusion: Devil and God: Co-existing. Perfusion 33: 4-5.
3. Roberts
DJ, Field S, Delaney M, Bates I (2016) Problems and approaches for blood
transfusion in the developing
countries. Hematol Oncol Clin North Am 30: 477-495.
4. Kokcu
AT (2020) Quality of the blood donation campaign in the military: A sample from
Turkey. Transfus Clin Biol 27: 30-35.
5. Kavaklioglu
AB, Dagci S, Oren B (2017) Determination of health workers’ level of knowledge
about blood transfusion. North Clin Istanb 4: 165-172.
6. Obi
EI, Pughikumo OC, Korubo KI, Ejele AO (2020) Prevalence of clinically
significant antibodies in patients undergoing elective surgery in a Nigerian
teaching hospital: A case for the type and screen method. Niger J Clin Pract
23: 138-146.
7. The
Sanguis Study Group (1994) Use of blood products for elective surgery in 43
European hospitals. Transfus Med 4: 251-268.
8. Baele
P (1994) Transfusion depends on the doctor, not on the patient: The Gangues
study of transfusion in elective surgery in Europe. Acta Anaesthesiol Belg 45:
3-4.
9. Napier
JA, Biffin A (1983) The importance of crossmatch/transfusion ratio and
intervals between successive cross-matches in determining red cell outdate
rates. Clin Lab Haematol 5: 379-385.
10. Torun
YA, Kaynar LG, Karakükcü C, Yay M, Kurnaz F, et al. (2012) ABO and Rh Blood
Group Distribution in Kayseri Province, Turkey. Turk J Haematol 29: 97-98.
-
Table 1
QUICK LINKS
- SUBMIT MANUSCRIPT
- RECOMMEND THE JOURNAL
-
SUBSCRIBE FOR ALERTS
RELATED JOURNALS
- Journal of Otolaryngology and Neurotology Research(ISSN:2641-6956)
- Journal of Cancer Science and Treatment (ISSN:2641-7472)
- Journal of Neurosurgery Imaging and Techniques (ISSN:2473-1943)
- Advance Research on Endocrinology and Metabolism (ISSN: 2689-8209)
- Journal of Carcinogenesis and Mutagenesis Research (ISSN: 2643-0541)
- Chemotherapy Research Journal (ISSN:2642-0236)
- International Journal of Diabetes (ISSN: 2644-3031)
