Nuttall G A, Santrach P J, Oliver W C, Horlocker T T, Shaughnessy W J, Cabanela M E, Bryant S
Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, USA.
Transfusion. 1996 Feb;36(2):144-9. doi: 10.1046/j.1537-2995.1996.36296181927.x.
Most blood crossmatched in a hospital blood bank is for surgical patients, and the majority is never transfused. The maximal standard blood order schedule is used to promote efficient ordering practices for surgical patients.
To ascertain the predictors of red cell transfusions for patients undergoing total hip arthroplasty, the charts of 299 adult patients undergoing primary and revision total hip arthroplasty were reviewed. A surgical blood order equation was developed for calculating the number of units of red cells that should be ordered. Stepwise regression analysis was used to determine which patient-and-case-related variables should be considered in the surgical blood order equation.
The significant indicators for allogeneic red cell transfusion to patients on the day of total hip arthroplasty were preoperative hemoglobin concentration, weight, age, estimated blood loss, and aspirin use. The surgical blood order equation would result in a lower crossmatch-to-transfusion ratio than would the maximal standard blood order schedule (1.23 vs. 3.14). Costs were also lower with the surgical blood order equation.
Incorporation of patient factors resulted in increased efficiency of blood-ordering practices in total hip arthroplasty.
医院血库中大多数交叉配血是为手术患者进行的，且大部分血液从未被输注。最大标准用血计划用于促进手术患者的高效用血安排。
为确定全髋关节置换术患者红细胞输注的预测因素，回顾了299例接受初次和翻修全髋关节置换术的成年患者的病历。制定了一个手术用血订单计算公式，用于计算应订购的红细胞单位数量。采用逐步回归分析来确定手术用血订单计算公式中应考虑哪些患者及病例相关变量。
全髋关节置换术当日患者接受异体红细胞输注的显著指标为术前血红蛋白浓度、体重、年龄、估计失血量和阿司匹林使用情况。与最大标准用血计划相比，手术用血订单计算公式会导致更低的交叉配血与输血比例（1.23对3.14）。使用手术用血订单计算公式成本也更低。
纳入患者因素提高了全髋关节置换术用血安排的效率。
