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A Prospective Single Centre Study of Preoperative Blood Ordering Versus Actual Usage Among Patients Undergoing Elective Curative Oncological Resections in a Tertiary Care Hospital in India

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Abstract

This study was a prospective, observational study aimed to look at the preoperative ordering schedule, pattern of usage of blood products for elective oncological surgeries in order to develop an institutional maximal surgical blood ordering schedule (MSBOS) in a tertiary university setting teaching Hospital. All biopsy proven, consenting, cancer patients of age 18 to 80 years who underwent elective curative cancer surgery over a period of 1 year were included. Various details such as nature of procedure, preoperative haemoglobin, intraoperative blood loss, duration of surgery, and number of units cross-matched and used were recorded and analysed. For each procedure, cross-match to transfusion (CT) ratio, transfusion index (TI), and transfusion probability (T%) were calculated using standard formulas. In all, 740 patients underwent elective curative cancer surgery in 1 year, majority being women and head and neck cancer being most common site. Overall, 312 patients received blood or component transfusion in the intraoperative and/or postoperative (within 48 h) period constituting 42% of all patients, although 70% of patients had preserved packed cells and 55% had preserved fresh frozen plasma (FFP). Cross-matching of blood was adequate only in cases of liver surgeries, maxillectomy, staging laparotomy for ovarian carcinoma, and urological malignancies with a desirable CT ratio falling within 2.5. An institution specific-MSBOS was developed. The study found a significant over-ordering of blood products. By implementing MSBOS, one can plan the collection and stocking of blood products thereby saving money, labour, and time.

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Authors and Affiliations

  1. Department of Surgical Oncology, Manipal Hospital, Bangalore, Karnataka, India

    Mohammed Basheeruddin Inamdar

  2. Department of Surgical Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati, AP, 517507, India

    Narendra Hulikal & Manilal Banoth

  3. Department of Surgical Gastroenterology, Sri Venkateswara Institute of Medical Sciences, Tirupati, AP, India

    Venkatrami Reddy

  4. Department of Transfusion Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, AP, India

    Sreedhar Babu Kinnera Vijay

  5. Department of Anaesthesiology and Critical Care, Sri Venkateswara Institute of Medical Sciences, Tirupati, AP, India

    Hanumanthu Rao Mangu

Authors
  1. Mohammed Basheeruddin Inamdar
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  2. Narendra Hulikal
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  3. Manilal Banoth
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  4. Venkatrami Reddy
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  5. Sreedhar Babu Kinnera Vijay
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  6. Hanumanthu Rao Mangu
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Correspondence to Narendra Hulikal.

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Inamdar, M.B., Hulikal, N., Banoth, M. et al. A Prospective Single Centre Study of Preoperative Blood Ordering Versus Actual Usage Among Patients Undergoing Elective Curative Oncological Resections in a Tertiary Care Hospital in India. Indian J Surg Oncol 12, 491–497 (2021). https://doi.org/10.1007/s13193-021-01354-0

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  • DOI: https://doi.org/10.1007/s13193-021-01354-0

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