Blood Transfusion during Neurological Surgery in a Sub-Saharan Tertiary Teaching Hospital-A Prospective Study
Abstract
Tobi KU, Azeez AL, Tudjugbe SO and Akpede GA
Introduction: Neurological surgeries are often associated with significant blood loss and high intraoperative and/ or subsequent blood transfusion requirements. This has led to high rate of routine preoperative blood grouping and cross-matching. More often, this translates to a high cross-match/transfusion ratio (CTR) and the consequent blood wastage, hence the need for this study. Objective: We sought to determine the scale of blood transfusion needs and associated factors during neurosurgical procedures.
Methods: This was a prospective study of patients who had elective and emergency neurological surgeries at the University of Benin Teaching Hospital. The significance of the relationship between intra-operative blood transfusion and pre-operative diagnosis, ASA physical status and preoperative haemoglobin concentration was determined using chi-square test.
Results: About 63.4% of the total patients who underwent neurological surgery had blood grouping and cross matching while 23.7% had intra-operative transfusions, giving a cross-match/ transfusion ratio (CTR) of 2.7:1. Intra-operative blood transfusion was significantly associated with the type and duration of surgery (P <0.001 each) and not with the preoperative haemoglobin concentration (P=1.000).
Conclusion: The routine cross-matching of blood may not be mandatory in the pre-operative preparation of all patients for neurological surgery. Rather, the type and duration of the procedure planned could be a useful guide.