A Study on Utilisation of Blood and Blood Components in a Tertiary Care Hospital in West Bengal, India

Introduction: Blood transfusion is an indispensable service component of inpatient as well as emergency management of care seeking patients in a hospital. Establishment of criteria for blood transfusion and adherence to such criteria is necessary to reduce blood wastage. It is necessary therefore, to conduct such studies for monitoring and improving transfusion practices as well as to find strategies for such improvement.

Aim: To evaluate the pattern and appropriateness of blood and blood components utilisation, the status of transfusion practice in the hospital and assessing the wastage of blood.

Materials and Methods: The present study was a retrospective record-based cross-sectional study. The data was collected in January-February 2021, from issue registers of blood bank of Burdwan Medical College and Hospital and also from the blood transfusion registers of the wards of Medicine, Obstetrics and Gynaecology, Paediatrics, Surgery and Orthopaedics Departments of Burdwan Medical College and Hospital using a pretested, predesigned schedule. For the month, June 2020, representative of the year 2020, details of Whole Blood (WB) and components cross-matched and transfused were noted. Utilisation rate (Units transfused×100/Units cross-matched) and blood utilisation quality indicators {Crossmatch/Transfusion Ratio (CTR=Number of units Cross-matched/Number of units transfused), Transfusion Probability (%T=Number of patients transfused/Number of patients cross-matched×100), Transfusion Index (TI=Number of units transfused/Number of patients cross-matched)2 and Wastage Rate (WR=Number of blood units discarded/Number of blood units issued×100)} were computed.

Results: Total 1,544 units were cross-matched for 1,324 patients and 1,219 units were transfused to 882 patients. Overall utilisation rate was 78.95%. Department-wise utilisation rates in descending order were paediatrics 98.25% (112/114), Medicine 90% (478/531), Gynaecology and Obstetrics 73.84% (254/344) and Surgery and Orthopaedics 66.62% (375/555) departments respectively. The overall quality indicators of blood utilisation were CTR of 1.27, %T of 67.52%, TI of 0.92 and WR of 21.05%, respectively.

Conclusion: Blood transfusion quality indicators demonstrated efficient blood utilisation. One-fifth of the cross-matched blood was not transfused. Non transfused blood units were not returned, resulting in wastage of blood, known as transfusion wastage. The overall utilisation rate was not acceptable. Higher blood wastage could be reduced with evidence-based blood utilisation strategies.