A PROSPECTIVE RANDOMIZED TRIAL OF THE SURGICAL BLOOD ORDER EQUATION FOR ORDERING RED-CELLS FOR TOTAL HIP-ARTHROPLASTY PATIENTS

BACKGROUND: The majority of crossmatched blood is for surgical patient s, and most of it is never transfused. An alternative system for order ing red cell (RBC) units, called theurgical blood order equation (SBOE ), which incorporates specific patient variables for surgical patients , has been developed. STUDY DESIGN AND METHODS: A prospective double-b lind randomized trial compared the SBOE with the maximal surgical bloo d order schedule (MSBOS) system for ordering allogeneic RBC units in 6 0 patients undergoing total hip arthroplasty. Autologous RBCs were ava ilable for none of the patients. RESULTS: There were no differences in patient demographic, surgical, or laboratory variables at any time. T he median number (range) of allogeneic RBC units ordered was 2 (2-3) f or the MSBOS and 0 (0-3) for the SBOE (p<0.0001). The SBOE ordered the correct number of RBC units for 58 percent of patients, while the MSB OS did so for 7 percent (p<0.0001). The SBOE had a lower crossmatch-to -transfusion ratio than the MSBOS (0.83 vs. 4.12). Costs were also low er with the SBOE. CONCLUSION: Incorporation of patient factors in the use of the SBOE system resulted in increased efficiency of blood-order ing practices for total hip arthroplasty.