Effectiveness of blood utilization across departments in a tertiary health institution

Intruduction: The limited availability of blood makes it imperative that Hospitals and transfusion centres employ blood utilization indicators to ensure effective and efficient use. This study is a review of the transfusion practices and blood utilization Indicators of the largest tertiary health centre in South East Nigeria. Material and methods: The study is a retrospective cross-sectional Hospital based type. The following, biodemographic data, clinical diagnosis, and blood bank information such as patient and donor blood types from a 3-year period (January 2018–January 2021) was reviewed. The total number of units crossmatched, issued, transfused, or returned was extracted. Utilization Indicators such as crossmatch to transfusion ratio, transfusion probability, and transfusion index were calculated and our findings were compared to similar studies performed in centres located in India, Ethiopia and Saudi Arabia Results: A total of 2,919 blood units were cross-matched out of which 2,212 units were transfused to 1,953 patients. The study reported an overall crossmatch to transfusion rate of 1.3, a Transfusion probability of 71%, and a transfusion index of 1.1. These findings compare favourably with findings reported from studies done in other LMIC countries. Comparatively, the Department of Medicine with a crossmatch to transfusion ratio of 1.1 has the most efficient blood ordering practices. Conclusion: The study findings showed that the quality indicators on the utilization of blood are in keeping with international best practices. Implementation of policies like the Maximum surgical blood ordering schedule (MSBOS) could further strengthen the practice and improve the results of the surgical disciplines

Impact of binet staging versus tumour bulk on treatment outcome in chronic lymphocytic leukaemia

Background: Most of the predictive tools put up to prognosticate treatment outcomes in patients with chronic lymphocytic leukaemia (CLL) are not easily available and affordable in our resource-constrained environment. Aim: The aim of this study was to evaluate the impact of staging and some tumour bulk on treatment outcomes of persons with CLL, Enugu, Nigeria. Patients and Methods: This is a 10-year review of the CLL data from the haemato-oncology unit of a Nigerian tertiary hospital to evaluate the impact of staging and tumour bulk indicators. Data were retrieved from the case notes of 102 patients with CLL receiving care at the facility. Data of interest include basic demographic variables, clinical features including spleen size and disease staging and blood counts. Statistical analysis was done using SPSS version 22. Results: The median absolute lymphocyte count (ALC) was 108.05 (confidence interval [CI] = 50.8–201.3, interquartile range [IQR] = 124.4) ×109/L, and duration of survival for the study cohort was 5.5 (CI = 3.5–31.9, IQR = 27) months. Majority (69, 79.3%) were in Stage C. The Binet stage showed a significant association with the ALC (r = 0.338; P = 0.002) but not with spleen size (r = 0.198; P = 0.056). The duration of survival only showed a significant inverse relationship with the ALC (r = 0.35, P = 0.006) but with neither the Binet stage (r = 0.103, P = 0.431) nor spleen size (r = 0.184, P = 0.116). Conclusion: In CLL patients, ALC at presentation correlates with the duration of survival. We recommend that the ALC at presentation be used as a prognostic marker in our clime