Pattern of blood ordering, cross matching and utilization in the surgical suites of Kenyatta National Hospital (KNH)
Abstract
This was a 3 months prospective study carried out at KNH on pattern
of blood ordering, cross matching and utilization. Patients who satisfied
the study criteria were recruited from elective theatre list of surgical
suites of KNH that include: general Surgery, orthopaedic surgery.
Paediatric surgery, plastic surgery , cardiothoracic surgery and
neurosurgery units.
The following details were recorded for every patient; age, sex,
occupation, religion, level of formal education, duration of illness
resulting in admission for surgery, duration of waiting for admission
after the patient was booked for elective operation, planned surgery
type, patient ABO blood group and Rhesus D status and amount of
blood requested for that particular operation .
Subsequent follow up of patient's blood request was done at BTU and
amount of blood crossmatched and its ABO blood group and Rhesus D
for that particular operation were recorded.
After the operation, details of blood transfused or not transfused were
recorded. Between the third and fifth postoperative day, blood was
drawn from the patients and analyzed for haemoglobin, white blood
cell count, platelets, sodium and potassium levels.
On discharge of the patients, duration of hospital stay was recorded.
Only 119 patients whose age ranged between two weeks and 87 years
were studied. The results revealed that:-
• The peak age group range was 21 - 30 years (20%)
• The male (68) to female 51 ratio was 1.3:1
• The ratio of Christians (107) 51% to Muslims (12) 9:1
• Education level in the study population was in the order of, no
formal education 29.4%, Primary 31.9%, Secondary 29.4%,
College 9.2% of the study population.
• Majority of the study patients (62.2%) were unemployed.
Duration of illness that patients waited before seeking medical
attention ranged from 0 - 1 0 weeks with a peak duration of > 8
weeks(53%).
• Duration of waiting for surgery after diagnosis was made ranged
from 0 to greater than 8 weeks. Majority of the patients (72%)
waited for 2 weeks or less before being operated on.
• Majority of the study patients had ABO Blood group O
Rhesus D+ (66.1%)
• Majority of the surgical procedures done were in the general
surgical unit (28%)followed by orthopaedic surgical unit (24%)
• The main cause of rescheduled operations was due to lack of
appropriate ABO Rhesus D Blood (96%).
• The mean preoperative haemoglobin levels ranged from
11.6- 14.5 g/dl (55%)
• Blood transfusion in the elective procedures that were performed
in this study were mainly intra operative (88%)
The mean post operative haemoglobin levels for transfused
patients and patients not transfused was (11.6 - 14.5) g/dl
Elective surgical procedures performed were predominated by
craniotomy and excition of brain tumor (10.9%)
The crossmatch to transfusion ratio (C/T) was <2.5:1
in 16 (39%) of the elective surgical Proedures done,
with 15 (36.6%) as having a transfusion probability
(T/P) of >30%.
Maximum surgical ordering blood schedule for total hip
replacement is one unit of blood.
Majority of the blood from BTU to the surgical units were utilized
in the cardiothoracic unit (41.4%)
Mean duration of hospital stay for transfused patients
was 27 days and for not transfused patients 29 days.
It is concluded from this study that it is possible to designate
MSOBS for elective surgical procedures in KNH.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
The following license files are associated with this item: