Efficiency of blood utilization and characteristics of patients receiving blood transfusion at an associated hospital in North India

Irm Yasmeen, Ibrar Ahmed, Shazia Bashir


Background: Blood is the liquid connective tissue composed of cells and plasma. It is the most precious and unique gift that one person gives to another. Blood banks are not the manufacturing factories. It can only be available on replacement basis. Periodic review of blood components usage is essential to assess the blood utilization pattern in hospitals. This study was conducted to analyse the efficiency of blood utilization and to minimize the inappropriate use of blood.

Methods: A retrospective cross-sectional study was conducted in the department of blood transfusion and immunohematology, government medical college and associated hospital, Rajouri for a period of one year with effect from November 2019 to November 2020. Data was collected using blood bank record. Blood utilization was calculated using crossmatch to transfusion ratio (C/T), transfusion probability (T%) and transfusion index (TI) indices.

Results: A total of 974 patients were requested to prepare 1270 crossmatched units. Of these 1141 blood units were transfused for 664 patients. The total donations during that period were 1197. 998 donors were replacement donors and 199 were voluntary non-remunerated blood donors donated at various blood donation camps. The overall values of C/T, T% and TI were 1.1:1, 68.1% and 1.1 respectively.

Conclusions: Blood utilization indices show efficient usage of blood. However, a blood ordering policy (MSBOS) must be developed to guide the clinicians regarding blood usage which can decrease overordering of blood thereby reducing unnecessary usage of reagents, manpower and also wastage of blood due to outdating.



Blood transfusion, Blood utilization, Anemia

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Patel P, Patel S, Patel M. Study of blood donor characterstics at teaching hospital, Western India. NJIRM. 2015;6:56-62.

Reiss RF. Blood donor well-being: A primary responsibility of blood collection agencies. Ann Clin Lab Sci. 2011;41:3-7.

Vibhute M, Kamath SK, Shetty A. Blood utilization in elective surgical cases: requirements, ordering and transfusion practices. J Post Med. 2000;46:13-7.

Rund RL, Bird AR, James MFM. Blood usage in elective surgery: a 3-month audit at Groote Schur hospital, Cape Town. South Afr Med J. 1992;81:415-8.

Avulselvi S, Rangarajan K, Sunita S, Misra MC. Blood transfusion practices at a level one trauma centre: A one-year retrospective review. Singapor Med J. 2010;51:736-40.

Kuchhal A, Negi G, Gaur DS, Harsh M. Blood utilization practices in elective surgical patients in a tertiary care hospital of Uttarakhand. Glob J Trans Med. 2016;1:51-56.

Eder AF, Dy BA, Perez JM. The residual risk of transfusion related acute lung injury at the American Red Cross (2008-2011): limitations of a predominantly male donor plasma mitigation strategy. Transfusion 2013;53:1442-9.

Wiersum Osselton JC, Middelburg RA, Beckers EA. Male only fresh frozen plasma for transfusion related acute lung injury prevention: before and after comparative cohort study. Transfusion. 2011;51:1278-83.

Markowitz MA, Waters JH, Ness PM. Patient blood management: a primary theme in transfusion medicine. Transfusion. 2014;54:2587.

Gaur D, Negi G, Chauhan N, Kusum A, Khan S, Pathak VP. Utilization of blood and components in a tertiary care hospital. Indian J Hemat Blood Transfusion. 2009;25:91-5.

Missal S, Sarate D, Athram G. A cohort study of distribution and utilization of blood and its components in a tertiary care hospital. GJRA. 2018;7(4):41-4.

Ho O, Bo B. Blood utilization in elective surgical procedures in Ilorin. Trop J Health Sci. 2006;13:15-7.

Pozo EA, Rosales PM, Almeida-Neto CD, Remesar MC, Cortes AD, Delgado RB et al. A comparision protocol to evaluate the use of blood and its components in latin America and the Carribbean. Rev Panam Salud Pub. 2015;37:435-41.

Friedman BA, Oberman HA, Chadwick AR. The maximum surgical blood order schedule and surgical blood use in the united states. Transfusion. 1976;16:380-87.

Kaur D, Kandwal M. Blood utilization and quality indicators- trend at a superspeciality hospital in Northern India. Hematol Transfus Int J. 2016:2(3):53-6.

Belayneh T, Messele G, Abdissa Z. Blood requisition and utilization practice in surgical patients at university of Gondar Hospital, North west Ethiopia. J Blood Transfus. 2013;1-5.

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. An analysis of blood utilization for elective surgery in a tertiary medical centre in Malaysia. Malays J pathol. 2002;24(1):59-66.

Mead JH, Anthony CD, Sattler M. Hemotherapy in elective surgery. An incidence report, review of the literature and alternatives for guideline appraisal. J Clin Pathol. 1980;74(2):223-7.

Zewdie K, Genetu A, Mekonnen Y, Worku T, Sahlu A, Gulilalt D. Efficiency of blood utilization in elective surgical patients. BMC Health Services Res. 2019;19:804.