A study of an educational intervention to decrease inappropriate preoperative autologous blood donation: its effectiveness and the effect on subsequent transfusion rates in elective hysterectomy

BACKGROUND: Decreasing the overcollection of preoperative autologous blood is difficult to achieve. The purpose of this study was to determine whether an educational intervention designed to outline the risks of preoperative autologous collection can decrease such donations and, if so, to determine how this decrease will affect subsequent transfusion rates. STUDY DESIGN AND METHODS: An educational intervention consisting of a didac tic presentation to the Department of Gynecology staff about the risks and benefits of autologous blood was implemented. Written material with similar information was given to patients. Subsequently, the percentage of patient s donating autologous blood, the number of autologous units donated, and th e rates of transfusion in patients eligible for autologous donation who wer e admitted for elective abdominal or vaginal hysterectomy were measured. Th ese rates were compared to those in similar patients admitted in the 2 year s before the educational intervention. RESULTS: After an educational intervention, the proportion of patients dona ting autologous blood decreased from 53 percent to 26 percent (p < 0.01), a nd the number of units collected per patient decreased from 0.86 to 0.31 (p < 0.01); this resulted in a savings of 80 autologous donations per year. D espite no difference in estimated blood loss (p = 0.46), the overall transf usion rate decreased from 10 percent to 3.7 percent (p = 0.03), while the a llogeneic transfusion rate demonstrated no significant change (1.1% vs. 2.2 %; p = 0.40). CONCLUSIONS: Unnecessary preoperative autologous donations by elective hyst erectomy patients can be decreased by educating physicians and patients abo ut the risks of preoperative autologous blood donation. Decreasing such unn ecessary donations can decrease the subsequent autologous transfusion rate, with its attendant risks, without increasing the risk of allogeneic transf usion.