Indicators and effects of blood transfusion in surgically treated urology patients

Abstract

Objective: To establish the determining factors for blood transfusion and its effects in urological surgery. Design: A five years’ hospital based descriptive, retrospective, cohort study. Setting: The surgical wards of Moi Teaching and Referral Hospital (MTRH), a 750-bed tertiary centre in the Western region of Kenya. Subjects: Sixty patients in a 420 cohort that underwent various types of surgery for urological problems. Materials and Methods: Patients who underwent surgery for urological problems were identified from the theatre registry. The files were retrieved from the records department and those complete for the sought data had the information extracted in line with a data sheet designed in keeping with the outlined objectives. The gathered data was confirmed for completeness, coded and then entered into a computer using SPSS software version 17.0 that was used for analysis. The data was analysed for descriptive statistics of central tendency, distribution, odds ratios, relative risks and correlation. Inferential statistics assumed a 95% confidence interval with an alpha value of 0.05 and so was taken to be statistically significant at p value ≤ 0.05. Main outcome measures: The primary outcome measures were the determinants of blood transfusion. The secondary outcome measures were the effects of blood transfusion on morbidity and mortality. Morbidity was represented by postoperative complications and length of hospital stay. Results: There was a 14.3% rate of blood transfusion with a male to female ratio of 7.6:1. The amount of blood transfused ranged from one to nine whole blood units with a mean and mode of 2.3 and 2 units respectively. Age of transfused patients ranged from 12 years to 86 years with mean ± standard deviation of 61.2 ± 17.5 years. The need for blood transfusion depended on age, type of surgery, type of anesthesia used and the duration of surgery. Transfused patients had longer hospital stay, more postoperative complications and greater mortality rate than those not transfused. Conclusion: The principal indicators of need for blood transfusion in urological surgery are existence of co morbid conditions, the type of surgery done, the type of anesthesia administered and the duration of surgery. Blood transfusion in surgically treated urology patients negatively impacts on the morbidity and mortality with increase in the length of hospital stay, postoperative complications and mortality rate