BASELINE ASSESSMENT OF TRANSFUSION EFFICIENCY BEFORE PATIENT BLOOD MANAGEMENT IMPLEMENTATION IN A TRAUMA AND ORTHOPEDICS HOSPITAL IN MEXICO
- 1General Hospital No. 20, Mexico;
- 2High-Specialty Trauma and Orthopedics Hospital, Mexico
Abstract
Introduction: Patient Blood Management requires local baseline indicators to identify inappropriate pretransfusion testing and guide improvement strategies. In trauma and orthopedic hospitals, routine perioperative crossmatching may exceed the actual transfusion requirement, increasing laboratory workload and limiting blood bank efficiency. Objective: To evaluate transfusion efficiency through the crossmatch-to-transfusion ratio in a tertiary trauma and orthopedic hospital in Mexico from 2020 to 2025, as a baseline before Patient Blood Management implementation. Materials and methods: Observational, descriptive, retrospective, longitudinal study based on monthly administrative records from the transfusion service. The study included all crossmatches and transfused blood components registered from January 2020 to December 2025. Annual and global totals were calculated. Transfusion efficiency was assessed using the crossmatch-to-transfusion ratio, defined as the number of crossmatches divided by the number of transfused components, and the transfusion utilization rate, defined as transfused components divided by crossmatches multiplied by 100. A crossmatch-to-transfusion ratio ≤2.5 was considered compatible with efficient blood ordering. Results: During the six-year period, 118,414 crossmatches and 21,076 transfused components were recorded. The global crossmatch-to-transfusion ratio was 5.62, with an overall transfusion utilization rate of 17.8%. Annual ratios were above the efficiency reference value in all years analyzed: 4.40 in 2020, 5.43 in 2021, 6.51 in 2022, 6.38 in 2023, 3.65 in 2024, and 7.82 in 2025. The best relative performance was observed in 2024, with a utilization rate of 27.4%, whereas 2025 showed the lowest efficiency, with a ratio of 7.82 and utilization of 12.8%. Discussion and conclusion: The institution showed suboptimal transfusion efficiency, with a marked gap between crossmatches performed and components ultimately transfused. These findings suggest over-ordering or low conversion of compatibility testing into effective transfusion. The results provide an institutional baseline before Patient Blood Management implementation and support targeted interventions such as transfusion audits, standardization of preoperative blood ordering, use of type-and-screen strategies for low-risk procedures, and development of a procedure-specific maximum surgical blood order schedule. Monitoring the crossmatch-to-transfusion ratio and utilization rate may help assess the future impact of Patient Blood Management on transfusion practice.
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BibTeX
@article{garcia2026baseline,
title = {{BASELINE ASSESSMENT OF TRANSFUSION EFFICIENCY BEFORE PATIENT BLOOD MANAGEMENT IMPLEMENTATION IN A TRAUMA AND ORTHOPEDICS HOSPITAL IN MEXICO}},
author = {Carolain ULLRICH GARCIA and Juan Carlos SANCHÉZ SERRANO},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.107364},
url = {https://doi.org/10.1016/j.htct.2026.107364},
note = {CC BY},
}
RIS
TY - JOUR
TI - BASELINE ASSESSMENT OF TRANSFUSION EFFICIENCY BEFORE PATIENT BLOOD MANAGEMENT IMPLEMENTATION IN A TRAUMA AND ORTHOPEDICS HOSPITAL IN MEXICO
AU - Carolain ULLRICH GARCIA
AU - Juan Carlos SANCHÉZ SERRANO
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.107364
UR - https://doi.org/10.1016/j.htct.2026.107364
AB - Introduction: Patient Blood Management requires local baseline indicators to identify inappropriate pretransfusion testing and guide improvement strategies. In trauma and orthopedic hospitals, routine perioperative crossmatching may exceed the actual transfusion requirement, increasing laboratory workload and limiting blood bank efficiency. Objective: To evaluate transfusion efficiency through the crossmatch-to-transfusion ratio in a tertiary trauma and orthopedic hospital in Mexico from 2020 to 2025, as a baseline before Patient Blood Management implementation. Materials and methods: Observational, descriptive, retrospective, longitudinal study based on monthly administrative records from the transfusion service. The study included all crossmatches and transfused blood components registered from January 2020 to December 2025. Annual and global totals were calculated. Transfusion efficiency was assessed using the crossmatch-to-transfusion ratio, defined as the number of crossmatches divided by the number of transfused components, and the transfusion utilization rate, defined as transfused components divided by crossmatches multiplied by 100. A crossmatch-to-transfusion ratio ≤2.5 was considered compatible with efficient blood ordering. Results: During the six-year period, 118,414 crossmatches and 21,076 transfused components were recorded. The global crossmatch-to-transfusion ratio was 5.62, with an overall transfusion utilization rate of 17.8%. Annual ratios were above the efficiency reference value in all years analyzed: 4.40 in 2020, 5.43 in 2021, 6.51 in 2022, 6.38 in 2023, 3.65 in 2024, and 7.82 in 2025. The best relative performance was observed in 2024, with a utilization rate of 27.4%, whereas 2025 showed the lowest efficiency, with a ratio of 7.82 and utilization of 12.8%. Discussion and conclusion: The institution showed suboptimal transfusion efficiency, with a marked gap between crossmatches performed and components ultimately transfused. These findings suggest over-ordering or low conversion of compatibility testing into effective transfusion. The results provide an institutional baseline before Patient Blood Management implementation and support targeted interventions such as transfusion audits, standardization of preoperative blood ordering, use of type-and-screen strategies for low-risk procedures, and development of a procedure-specific maximum surgical blood order schedule. Monitoring the crossmatch-to-transfusion ratio and utilization rate may help assess the future impact of Patient Blood Management on transfusion practice.
SN - 2531-1379
SN - 2531-1387
ER -