Analysis of cross matching to transfusion ratio of blood components in blood bank SKIMS, Soura: a prospective one year study

Supinder Kour, Irm Yasmeen, Aleem Jan, Balwinder Singh


Background: Blood requisitions received in blood bank for elective and emergency procedures from surgery, trauma, Obstetrics and Gynaecology Department are often associated with excessive demand for cross matching of blood which is often more than the required blood and blood components. In this study, our goal was to use the blood stocks more efficiently and reduction in the wastage due to over dating and to prevent injudicious pre-operative cross-matching and utilization of blood.

Methods: This was a prospective study conducted in the Department of Blood Transfusion and Immunohematology of Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar over a period of one year with effect from September 2017 to August 2018. Source was requisition forms and blood bank records of patients who underwent elective procedures in the hospital. For the purpose of analysis, departments were categorized into surgical and allied branches i.e Cardiovascular Surgery (CVTS), Neurosurgery, General Surgery and Obstetrics and Gynaecology. Department wise utilization of blood Components cross matching to Transfusion ratio (C/T), transfusion probability (T%) and Transfusion Index (TI) were calculated. Data was entered and analyzed using Microsoft excel window 2010. The obtained data was evaluated and presented in the tabular and diagrammatic forms.

Results: A total of 3940 requests for cross matching of blood and its components were received for 3072 patients. Out of these, 2048 units were transfused. The total C/T Ratio, Transfusion Probability (T%) and Transfusion Index (TI) was 1.92, 42.5% and 0.6 respectively.

Conclusions: To reduce the injudicious usage of blood, blood transfusion services need to adopt blood conserving policies. Efforts should be made to adopt more conservative transfusion thresholds, periodic feedback to improve blood ordering, conduct regular auditing, handling, distribution and utilization practices of this scarce resource.


Maximum surgical blood ordering schedule, Transfusion index, Transfusion probability

Full Text:



Vibhute M, Kamath SK, Shetty A. Blood utilisation in elective general surgery cases: requirements, ordering and transfusion practices. J Postgraduate Med. 2000;46(1):13.

Goodnough LT, Maggio P, Hadhazy E, Shieh L, Hernandezā€Boussard T, Khari P, et al. Restrictive blood transfusion practices are associated with improved patient outcomes. Transfusion. 2014;54(10pt2):2753-9.

Zimmermann R, Buscher M, Linhardt C, Handtrack D, Zingsem J, Weisbach V, et al. A survey of blood component use in a German university hospital. Transfusion. 1997;37(10):1075-83.

Ali A, Auvinen MK, Rautonen J. Blood donors and blood collection: The aging population poses a global challenge for blood services. Transfusion. 2010;50(3):584-8.

Raghuwanshi B, Pehlajani NK, Sinha MK, Tripathy S. A retrospective study of transfusion practices in a Tertiary Care Institute. Ind J Anaesth. 2017;61(1):24.

Sowayan SA. Use of blood in elective surgery: an area of wasted hospital resource. Annal Saudi Med. 1994;14(4):326-8.

Friedman BA, Oberman HA, Chadwick AR, Kingdon KI. The maximum surgical blood order schedule and surgical blood use in the United States. Transfusion. 1976;16(4):380-7.

Olawumi HO, Bolaji BO. Blood utilization in elective surgical procedures in Ilorin. Trop J Health Sci. 2006;13(1):15-7.

Kuchhal A, Negi G, Gaur DS, Harsh M. Blood utilization practices in elective surgical patients in a Tertiary Care Hospital of Uttarakhand. Global J Transfusion Med. 2016;1(2):51.

Kaur D, Kandwal M. Blood utilization and quality indicatorsā€“Trend at a superspeciality hospital in Northern India. Haematol Transfusion Intern J. 2016;2(3):00037.

Tayara BK, Al-Faraidy MH, Al-Sayel FA, Al-Omran AS, Sadat-Ali M. Blood utilization in orthopedic and trauma practice. Int J Applied Basic Med Res. 2015;5(2):111.

Bashawri LA. Pattern of blood procurement, ordering and utilization in a University Hospital in Eastern Saudi Arabia. Saudi Med J. 2002;23(5):555-61.

Ibrahim SZ, Mamdouh HM, Ramadan AM. Blood utilization for elective surgeries at main University Hospital in Alexandria, Egypt. J Am Sci. 2011;7(6):683-9.

Jayaranee S, Prathiba R, Vasanthi N, Lopez CG. An analysis of blood utilization for elective surgery in a tertiary medical centre in Malaysia. Malaysian J Pathol. 2002;24(1):59-66.

Subramanian A, Rangarajan K, Kumar S, Sharma V, Farooque K, Misra MC. Reviewing the blood ordering schedule for elective orthopedic surgeries at a level one trauma care center. J Emergencies, Traumaand Shock. 2010;3(3):225.

Yasmeen I, Ahmed I, Sidhu M. Pattern of blood component cross-matching and their utilization in a tertiary care hospital of Jammu region. Int J Res Med Sci. 2018;6(4):1337.

Sadhana M, Neha B, Pinky Y, Rakesh C. Optimization of blood transfusion services: Analysis of blood requisition and utilization practices in cardiac surgical patients in a tertiary care hospital, India. Glob J Trans Med. 2017,2(1):47-51.

Raghuwanshi B, Pehlajani NK, Sinha MK, Tripathy S. A retrospective study of transfusion practices in a Tertiary Care Institute. Ind J Anaesth. 2017;61(1):24.

Kaur P, Basu S, Kaur G, Kaur R. An analysis of the pattern of blood requisition and utilization-A tertiary care centre. NJIRM. 2013; 4(2): 123-27.

Devi KM, Barindra Sharma A, Dorendro Singh L et al. Quality indicators of blood utilization in a tertiary care centre in Northeastern India. IOSR J Dent Med Sci. 2014; 13(1): 50-52.