Analysis of the intraoperative use of red blood cells and reserve index/transfusion at a University Hospital in Bogotá, Colombia
Transfusions are usual perioperative procedures. Always keep in mind that this is a costly procedure and is not risk-free, but you must be clear about what patients will benefit from having a reserve/transfusion to avoid wasting resources.
To establish the transfusion index and risk factors associated with perioperative transfusions administered at a third-level hospital in Bogotá, Colombia.
Historical cohort study in 490 patients undergoing elective or emergency surgery with red blood cells reserve. The reserve/transfusion index was estimated and all factors associated with perioperative transfusions were identified.
The transfusion index for neurosurgical procedures was 9, representing redundant reserves. General and pediatric surgery were risk factors for transfusion with relative risk (RR) 1.95 (95% CI 1.55-2.46) P < 0.0001, similar to cardiovascular surgery with RR 2.16 (95% CI 1.74-2.69) P < 0.0001. Emergency procedures represented RR 2.27 (95% CI 1.84-2.81) P < 0.0001. Regional anesthesia was a protective factor with RR 0.347 (95% CI 0.23-0.51) P < 0.0001. Age above 52 years with RR 0.585 (95% CI 0.46-0.73) P < 0.0001.
There is a need to reduce the amount of reserves based on the analysis of the actual use of red blood cells. Blood reserves shall be adapted to the ideal transfusion reserve index of less than 2.5 reserved units perevery unit transfused and, as far as possible, managing the risk factors for transfusion in patients under going surgery.
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