Madhusudana Hn, Akriti Kashyap, Sunita Patil, Gurpuneet Basra, Navnath Dighe, Sashindran Vk,
Volume 16, Issue 3 (May-Jun 2022)
Abstract
Background and objectives: Intraoperative blood transfusion is a common medical intervention worldwide. Although mostly lifesaving when indicated, inappropriate administration of intraoperative can be potentially life-threatening. The aim of this study was to analyze the most common surgery/invasive procedures requiring intraoperative transfusion and to determine indications for intraoperative transfusion as well as the outcome of the patients after intraoperative transfusion.
Methods: A retrospective review of the electronic database of medical records was done for surgical patients who received intraoperative transfusion from June 2019 to December 2019. Preoperative hemoglobin values, associated comorbidities, and physiological triggers including hypotension and tachycardia were recorded. Descriptive statistics were used to summarize the data.
Results: A total of 36 patients (age range: 9-80 years) were studied. Orthopedic surgeries (53%) were the most common surgeries that required intraoperative transfusion. Preoperative anemia (hemoglobin <10 g/dl) was the predominant reason for intraoperative transfusion. Type 2 diabetes mellitus (36.3%) was the most frequent comorbidity among the cases of intraoperative transfusion. Half the cases received two units of packed red blood cell (pRBC), while 39% of the cases received one unit of pRBC. The remaining 11.1% received more than two units of pRBC. Furthermore, 77.7% of the patients were discharged to home within a week, while 16.6% of the patients were discharged after a prolonged hospital stay (> one week). The remaining 5.5% died in the hospital within a week of the procedure/surgery.
Conclusion: Transfusion practices vary among physicians, hospitals, and countries. The findings highlight that the hospital might be the most important determinant of the number of administered transfusions, with some adopting programs to reduce transfusions for elective surgery.
Supriya Gulajkar, Rajni Shivkar, Sanjyoti Panchbudhe, Charushila Kadam,
Volume 19, Issue 1 (4-2025)
Abstract
Background and Objectives: Quality control (QC) is a crucial tool in the clinical laboratory for error identification and correction. While IQC ensures daily precision and accuracy, EQAS ensures long-term accuracy by providing external verification. The objective of this study was to evaluate our laboratory’s performance in the EQAS program and assess the impact of corrective actions on EQAS performance improvement.
Methods: The retrospective observational study was undertaken in the tertiary care hospital. The Biochemistry department of the laboratory participated in the monthly clinical chemistry EQA program administered by CMC Vellore EQAS. Nineteen parameters were assessed using structured approach to analyze deviating EQAS results. Monthly performance was analyzed in terms of the SDI (Standard Deviation Index) and VIS (variance index score) for the period of October 2019 to September 2021.
Results: Among the nineteen parameters assessed in EQAS program, most showed ‘excellent’ performance between October 2019 and September 2021 based on mean SDI. Some improvement was observed in the SDI values between the two cycles after implementing a structured approach in root cause analysis and indicates an enhanced level of performance in the EQAS program. The VIS analysis revealed that 89.47% of parameters in the October 2019 to September 2020 period and 94.73% in the October 2020 to September 2021 achieved scores classified as ‘very good’ performance.
Conclusion: Adopting a structured approach to analyze deviating EQAS results enables the evaluation of laboratory performance and offers opportunities for improvement. Consequently, EQAS plays a significant role as a cornerstone in the accreditation process.
