Use of the surgical blood order equation in spinal instrumentation and fusion surgery

Study Design. A retrospective review of 182 cases of adult spine instrument ation and fusion surgery (1994-1995) from one institution. Objectives. To develop and retrospectively evaluate the use of the surgical blood ordering equation for patients undergoing spinal instrumentation and fusion surgery. Summary of Background Data. The provision of effective and safe blood and b lood products is the primary function of the hospital transfusion service. A quantification of blood bank efficiency is the crossmatch-to-transfusion ratio. The maximal surgical blood order schedule system has been used to im prove the efficiency of surgical ordering practices, The current authors ha ve developed a theoretically more efficient system, the surgical blood orde ring equation, which incorporates patient factors for ordering red blood ce ll units for surgical patients. Methods, The charts of 63 patients with autologous red blood cells availabl e and 119 adult patients with none available, who underwent multilevel spin e surgery from January 1994 to July 1995, were reviewed. Results. The surgical blood ordering equation was exactly correct in the or dering for 37 (20.3%) of 182 patients. The maximal surgical blood order sch edule was exactly correct in ordering blood for 14 patients (7.6%). Use of the new surgical blood ordering equation to order red blood cells for surge ry would result in a lower crossmatch-to-transfusion ratio than with the cu rrent system, the maximal surgical blood order schedule, for patients with autologous red blood cells available (1.0 vs. 1.3) and patients with none a vailable (0.9 vs. 1.2). Conclusion. Incorporating patient factors resulted in increased efficiency of blood ordering practices.