Necessity for Regular Updates of the Maximum Surgical Blood Order Schedule (MSBOS)

Abstract

Background: The maximum surgical blood order schedule (MSBOS) is a list of surgical procedures with the corresponding recommended number of blood units. Nevertheless, with the advances in surgery and transfusion medicine, a need for updates in the MSBOS has been suggested. This study evaluated the need for regular revision of the MSBOS. Methods: The surgical procedures performed between August 2016 and July 2021 were investigated retrospectively. The transfused blood units for each type of surgery were analyzed in elective, single surgeries performed more than ten times per year. The Transfusion index (TI) and the Transfusion probability (TP) for each type of operation were calculated in five one-year intervals. Furthermore, the surgeries performed more than 10 times in all one-year intervals and presented a TI0.5 at least once during the study period were subjected to further analysis. Results: A total of 96,040 elective surgical procedures were performed during the five-year study period, including 77,639 single surgeries performed 10 times in one year. The average transfused blood units and the average TP per year decreased over time. In addition, the percentage of the number and type of operations presenting TI0.5 changed. Among the 27 surgeries that were further studied, six showed constant TI0.5; six changed from TI0.5 to 0.5, and 15 displayed fluctuations in TI. Conclusion: Changes in surgical blood utilization was observed among one-year periods, which implies the need for regular revision of MSBOS. (

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