Contributed equally as first authors to the manuscript.
Evaluation of preoperative and intraoperative red blood cell transfusion practices at Maputo Central Hospital, Mozambique
Article first published online: 21 MAY 2013
© 2013 American Association of Blood Banks
Volume 54, Issue 1, pages 42–48, January 2014
How to Cite
Burke, Z. D.C., Chen, J. B., Conceicao, C., Hoffman, R. M., Miller, L. T., Taela, A. and DeUgarte, D. A. (2014), Evaluation of preoperative and intraoperative red blood cell transfusion practices at Maputo Central Hospital, Mozambique. Transfusion, 54: 42–48. doi: 10.1111/trf.12252
This research has been supported by the President's Emergency Plan for AIDS Relief (PEPFAR) through the Health Resources and Services Administration (HRSA) under the terms of Cooperative Agreement U97HAO4128, the UCLA Program in Global Health Education and Center for World Health, the UCLA AIDS Institute, the Infectious Disease Society of American Education and Research Fund (IDSA ERF) Medical Scholar Program, and the NIH/NCRR/NCATS UCLA CTSI Grant UL1TR000124. The findings and conclusions presented are those of the authors and do not necessarily represent the official position of the funding agencies.
- Issue published online: 9 JAN 2014
- Article first published online: 21 MAY 2013
- Manuscript Accepted: 5 APR 2013
- Manuscript Revised: 2 APR 2013
- Manuscript Received: 22 JAN 2013
- President’s Emergency Plan for AIDS Relief (PEPFAR) through the Health Resources and Services Administration (HRSA). Grant Number: U97HAO4128
- UCLA Program in Global Health Education and Center forWorld Health, the UCLA AIDS Institute
- Infectious Disease Society of American Education and Research Fund (IDSA ERF) Medical Scholar Program
- NIH/NCRR/NCATS UCLA CTSI. Grant Number: UL1TR000124
The purpose of this study was to evaluate preoperative and intraoperative blood transfusion practices in Hospital Central (Maputo, Mozambique) and estimate the number of potentially avoidable transfusions.
Study Design and Methods
A retrospective cohort study was performed. Age, comorbidities, hemoglobin (Hb), the potential for blood loss, and units of red blood cell (RBC) transfusions were recorded. Preoperative transfusions were evaluated to determine whether they met criteria established by the Mozambican Ministry of Health as well as proposed guidelines based on more restrictive protocols. Avoidable blood transfusions were defined as those preoperative transfusions that were not indicated based on these guidelines. Multivariate logistic regression was used to identify factors that predicted transfusion.
A total of 205 patients (age range, 0.1-86 years) underwent surgery in the main operating room during the 2-week study period. Overall, 35 (17%) patients received 68 transfusions. Of these, 36 transfusions were given preoperatively and 32 were given intraoperatively. Thirty-six percent of preoperative transfusions were avoidable according to national guidelines. Ninety-two percent were avoidable using more restrictive guidelines. The primary predictors of preoperative blood transfusion were lower Hb (odds ratio [OR], 0.390/1 g/dL; p < 0.0001) and the potential for blood loss (OR, 3.73; p = 0.0410).
Adherence to existing Hb thresholds recommended by national blood transfusion guidelines could significantly reduce the number of transfusions and the association risk of transfusion-transmissible infections. Adoption of more restrictive guidelines is recommended to further improve blood transfusion utilization and further reduce the transmission risk of human immunodeficiency virus and hepatitis.