The Evaluation of Blood Requests for Transfusion and It’s Utilization in Four Iranian Hospitals

Abstract

Background: Transfusion is one of the most important elements of healthcare. In order to save human lives, 85 million blood units are used in the world annually. Access to blood products is a common problem throughout the world. Presently, demand is increasing significantly for blood usage. The main goal is to evaluate blood usage in four hospitals by comparing them with international standards and utilization of efficient methods to prevent unnecessary transfusions. Materials and Methods: This is a retrospective hospital based survey carried out at Tehran Blood Transfusion Centre. Data regarding blood transfusion requests, units requested, units cross matched, unused units returned and other details were collected from the blood bank laboratory records in four Iranian hospitals. The crossmatched to transfusion ratio was evaluated. Results: There were a total of 548,568 requests for units of blood in total. 196,059  units were  crossmatched  and 82,320 units  were transfused. The proportion of C/T (total) was 2.38 and the proportion of transfusions to the number of beds was 16. The C/T ratios for all hospitals were 2.38. Only 42% of blood cross matched units was utilized.  One of four hospitals in our survey which specializes in cardiac the C/T ratio is 1.86 and the ratio of blood infusion to hospital bed is 19.7.  Another hospital specializes in pediatric hematology oncology and C/T ratio is 1.04 (the ratio of blood infusion to hospital bed=19.6). A 1,000 bed general hospital with cardiac and oncology departments in which C/T ratio is 2.94. Conclusion: We saw over ordering requests of blood units which is different in 4 hospitals. The number of beds and departments can have a direct effect on the C/T ratio. The quantity of blood used depends on the number of beds and fields of specialization present at the hospital.   Suitable usage of blood depends on great hospital and number of expertise. There is a need to expand our hemovigilance teaching program. Use of abscreening helps to achieve a more efficient blood utilization and should be engaged in our locality to prevent unnecessary demands.