Descriptive study of perioperative transfusion practices in Spanish hospitals

SUMMARY In order to identify opportunities to enhance blood-sparing strategies, we studied blood-transfusion practices in patients undergoing scheduled major surgery in Spain. This prospective, multicenter epidemiological study involved 20 Spanish hospitals. We recorded the pre- and postoperative hemoglobin concentrations, the estimated and calculated blood loss, the number of patients transfused and the blood-sparing techniques used. A total of 359 patients from 18 centers were included in the analysis. Mean preoperative hemoglobin concentration was 13.7 ± 1.6 g/dL. In 29% of the patients, preoperative hemoglobin concentration was lower than 13 g/dL. All surgeries combined, mean estimated blood loss was 845 ± 659 mL and mean calculated blood loss 1722 ± 1021 mL. The percentage of patients transfused with allogeneic blood was 28.4% altogether and ranged from 47.2% in cardiac surgery patients to 4.5% in plastic-maxillofacial surgery patients. Blood-sparing techniques were used only in 70 patients (19.4%). For a large percentage patients who underwent scheduled major surgery, blood transfusion was needed and perioperative blood loss was underestimated. Blood-sparing techniques were underused in non-orthopedic surgery, despite the fact that sufficient time was available to plan appropriate blood-sparing measures.