Audit of blood transfusion practice during anaesthesia for spine surgeries in a regional trauma centre in Nigeria

Abstract

Background: Blood loss during spine surgery is often considerable, necessitating blood transfusion. The elective nature and other peculiarities of most spine surgeries, however, make them amenable to several blood conservation techniques, such that reduction in allogeneic blood transfusion is considered high priority in spine surgery. In view of the rise in spine procedures, facilitated by availability of enhanced imaging services, surgical and anaesthetic manpower, an audit of blood transfusion practice during spine surgeries in a regional trauma centre was deemed necessary.

Objective: To determine the extent of blood usage (autologous and allogeneic) during spine surgeries and evaluate the blood prescription practice in view of optimal utilization of blood cross-match services.
Methodology: A retrospective review of all 107 spine surgeries done over a period of 41/2years was carried out and the blood transfusion rate, autologous blood usage and blood utilization indices were determined.

Results: Forty-nine (46%) of 107 patients received blood transfusion, and only three patients received autologous blood. The cross-match /transfusion ratio, transfusion index and transfusion probability were 3.4, 0.7 and 45.8%, respectively. The maximum number of units of blood transfused to any single patient was 4units.

Conclusion: Whereas blood transfusion rate in the series is considerably high, the overall blood utilization is considered optimal. Autologous blood usage is abysmally low and institutional approach to encourage its optimal use is recommended to minimize allogeneic blood transfusion with its attendant complications and cost.

Keywords: Autologous, allogeneic, blood conservation, general anaesthesia, imaging facilities, prone position