Abstract
Background: The practice of transfusion for surgical patients has changed from replacing surgically lost blood with alloplastic transfusions to implementing strategies that reduce transfusion requirements. Although there are numerous and sometimes partially contradictory perioperative transfusion guidelines, implementation of perioperative transfusion guidelines is sometimes difficult due to local differences in clinicians' knowledge and experience and characteristics of surgery. The aim of this study was to evaluate perioperative transfusion practices in patients undergoing elective major surgery.
Methods: A cross-sectional study conducted in Damascus Hospital (Al-Mujtahid) in the period between November 2023 and February 2024. The study included patients of the following departments: general surgery, orthopedic surgery, neurosurgery, and vascular surgery. Patients who underwent selective surgeries before and after surgery were studied, and their number reached 130 patients.
Results: Our study included 148 patients; the percentage of males (60.1%) compared to females (39.9%). The largest age group was “45-69” (43.2%). The most common blood group is O+ (24.3%). More than half of the patients were not taking any medications (55.4%). Medications taken: anti-coagulant (7.4%), blood pressure and diabetes medications (2.7%). Medical history was: diabetes mellitus (8.1), diabetes and hypertension (6.1%). The type of surgery was as follows: orthopedic and general surgery (33.8%) each, neurosurgery (20.3%), and vascular surgery (12.2%). Blood transfusion was more frequent postoperatively (23%), and a higher percentage did not undergo a blood transfusion (27%). Whole blood transfusion was the most widely used strategy, especially in orthopedic surgeries.
Conclusion: We found that approximately 70% of patients who underwent major elective surgery underwent blood transfusions, to a lesser extent, to one or more of its derivatives, and the largest percentage, 23%, underwent blood transfusions postoperatively. Indications for blood transfusion included the hemoglobin threshold and the type of surgery.