USE OF BLOOD PRODUCTS FOR ELECTIVE SURGERY IN 43 EUROPEAN HOSPITALS

The objective of this study was to assess the use of blood products an d artificial colloids in six commonly performed elective surgical proc edures in 43 teaching hospitals in 10 European countries. 7,195 patien t data were analysed. For each product wide differences were found bet ween hospitals, both in the proportion of patients transfused and the amount of product used for the same patient category. Adjustment for a ge, gender, preoperative haematocrit and blood loss, left major differ ences among hospitals in patient red unit transfusion. Hospitals in th e Mediterranean area used less albumin and artificial colloids and mor e autotransfusion than those of central-northern Europe. The reasons f or perioperative red cell transfusion were stated in the patient's med ical record for 23% of patients. The ratio of preoperative blood reque st to transfusion was maximal in cholecystectomy, where it exceeded 10 . The documentation of blood request and transfusion, and of transfusi on complications in medical records, did not fully agree with that in the transfusion service in 49, 53 and 92% of the hospitals, respective ly. The wide differences in blood product used for the same patient ca tegory were due to a variety of causes of which only some could be exp lained by the clinical factors taken into account. This suggests that consensus conferences and guidelines have so far had a limited impact on transfusion practice in many clinical units, even in teaching envir onments.