Guduri Pruthvi Raj, Shastry Shamee, Raturi Manish, Shenoy Anitha
Head (Transfusion Medicine), The Mission Hospital, Durgapur, West Bengal, India.
Professor & Head (Immunohematology & Blood Transfusion), Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Med J Armed Forces India. 2022 Jul;78(3):283-290. doi: 10.1016/j.mjafi.2020.07.004. Epub 2020 Oct 9.
Overordering of blood has been a challenge faced by the blood bank staff. The present study addresses the role of maximum surgical blood ordering schedule (MSBOS) in optimizing the blood inventory management.
The blood requests for elective surgical procedures from various surgical departments were reviewed to constitute MSBOS. Transfusion profile was assessed using crossmatch to transfused units (C/T) ratio, transfusion probability (TP), and transfusion index (TI). A cutoff of 0.3 and 5% value of TI and TP, respectively, was considered to decide on the type of crossmatch. The efficacy of MSBOS implementation has been determined prospectively by unpaired t test using SPSS software, version 20 (IBM, USA).
A total of 2674 patients were studied. Overall red cell usage rate was 15%. The comprehensive C/T ratio was 4.57. The C/T ratios for the various departments ranged from 1 to 8.5 (adjusted C/T ratio). Highest C/T ratio was observed for surgical procedures performed in the specialties of otorhinolaryngology and urology. A C/T ratio greater than 5 was noted in 30.4% of different types of surgical procedures. Of the 176 different types of elective surgical procedures studied, type and screen protocol was applicable for 75.5% (133) of the procedures. After implementation of MSBOS, the number of crossmatches reduced by 2152 and total working time saved in our laboratory is close to 75,320 man hours.
MSBOS helps in identifying the common surgical procedures with low TP and is one of the efficient tools in preventing the overordering of the blood.
血液过度订购一直是血库工作人员面临的一项挑战。本研究探讨最大外科用血订购计划（MSBOS）在优化血液库存管理中的作用。
回顾了各外科科室择期手术的用血申请，以制定MSBOS。通过交叉配血与输注单位（C/T）比值、输血概率（TP）和输血指数（TI）评估输血情况。分别以TI和TP的0.3及5%作为临界值来决定交叉配血的类型。使用SPSS 20.0软件（美国IBM公司）通过非配对t检验前瞻性地确定实施MSBOS的效果。
共研究了2674例患者。总体红细胞使用率为15%。综合C/T比值为4.57。各科室的C/T比值在1至8.5之间（调整后的C/T比值）。耳鼻喉科和泌尿外科专科手术的C/T比值最高。30.4%的不同类型手术的C/T比值大于5。在所研究的176种不同类型的择期手术中，75.5%（133种）的手术适用血型鉴定和抗体筛查方案。实施MSBOS后，交叉配血数量减少了2152次，我们实验室节省的总工作时间接近75320工时。
MSBOS有助于识别TP较低的常见外科手术，是防止血液过度订购的有效工具之一。
