Blood transfusion practice in patients undergoing thyroidectomy in Ibadan, Nigeria

Abstract

Background: The demand on the blood bank in sub-Saharan Africa for blood is huge. There is, therefore, a need for more efficient use of this precious material. This study, therefore, was carried out to assess blood transfusion practice for thyroidectomy in a sub-Saharan African country.

Methods: A descriptive study of patients who had thyroidectomy over a 12 year-period was carried out. Information on clinical characteristics, blood loss and utilization were obtained prospectively. The blood utilization practice was assessed using Cross-match:Transfusion ratio (C:T), Transfusion probability (%T), and Transfusion index (TI). Maximum Surgical Blood Ordering Schedule (MSBOS) for thyroidectomy was derived.

Results: The data of 265 patients aged 11 – 71 years with a mean age of 40.8 ± 12.6 years were analyzed. The surgeons requested for cross-matched blood for 255 patients. Blood cross-match was carried out for 216 (84.7%) patients. The patients had an average pre-operative haematocrit of 37% and median blood loss of 200mls. Cross-match:Transfusion ratio (C:T) was 5.53 with a %T of 17.6% and TI of 0.22. The MSBOS was 0.33.

Conclusion: The routine cross-matching of blood is unnecessary for thyroidectomy in our clinical practice. The blood ordering practice for thyroidectomy should, therefore, be streamlined to reduce the cost and burden of the reservation of the units of blood to the transfusion services. The type and screen policy should be considered by the blood bank, surgeons, anaesthetists and the hospital transfusion committee.