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AUTOLOGOUS TRANSFUSION IN SURGICAL PATIENTS AT KE: YYATTA NATIONAL HOSPITAL, NAIROBI
Abstract
Objective: To identify autotransfusion strategies and their basis in elective surgery patients.
Design: A cross sectional prospective study.
Setting: General surgery and orthopaedic wards, Kenyatta National Hospital, Nairobi.
Subjects: Adult patients of both sexes planned for elective sure ery.
Main outcome measure: For every patient, the following were enql ired about and documented:
age in years, sex, ethnicity, religion, occupation and education: 11 standard. Blood values of
haemoglobin, platelet counts, total and diierential white cell cc bunts, urea, electrolytes and
liver function tests were assayed. Others were the number of UI lits of blood donated before
the operation, the type of surgery performed, time taken from diagnosis to performing the
operation and whether the blood was transfused preoperativel! , intraoperatively and postoperatively.
Results: A total of sixty three cases constituting five per cent of a U surgical patients admitted
during the period of study were evaluated. Of these 53 (84%) were males and ten (16%)
females. The age range was 15 to 65 years with a peak at 45-49 years. There were more
Christians (90%) than Muslims (10%). In all, 32 (51.6%) had primary school education, 23
(36.5 %) secondary school education, seven (11.3%) no formal ec lucation and one (1.6%) had
attained college level. Employment pattern showed 50% were c ivil servants, 30% were self
employed and 20% were unemployed. The duration of disease ranged from 1-24 weeks with
two peaks at two weeks and six weeks. Orthopaedic cases constituted 78.7% and general
surgery 21.3%. Preoperative haemoglobin ranged from 13.5-1 4.2 gtdl. Transfusions were
given intraoperatively to 41 (66.1 %) and to 12 (33.9%) postoperatively. Mean duration of
hospitalisation was 13 days (range 5 to 21 days). 98.4% deposited only one unit while 1.6%
deposited four units of blood. Only one patient required additional transfusion from
homologous donors.
Conclusion: The strategies and basis for autotransfusion have I teen demonstrated among a
majority of adult patients requiring orthopaedic procedures. Mi ljor determinants are shown
to be baseline blood count profdes and time to operation.
Design: A cross sectional prospective study.
Setting: General surgery and orthopaedic wards, Kenyatta National Hospital, Nairobi.
Subjects: Adult patients of both sexes planned for elective sure ery.
Main outcome measure: For every patient, the following were enql ired about and documented:
age in years, sex, ethnicity, religion, occupation and education: 11 standard. Blood values of
haemoglobin, platelet counts, total and diierential white cell cc bunts, urea, electrolytes and
liver function tests were assayed. Others were the number of UI lits of blood donated before
the operation, the type of surgery performed, time taken from diagnosis to performing the
operation and whether the blood was transfused preoperativel! , intraoperatively and postoperatively.
Results: A total of sixty three cases constituting five per cent of a U surgical patients admitted
during the period of study were evaluated. Of these 53 (84%) were males and ten (16%)
females. The age range was 15 to 65 years with a peak at 45-49 years. There were more
Christians (90%) than Muslims (10%). In all, 32 (51.6%) had primary school education, 23
(36.5 %) secondary school education, seven (11.3%) no formal ec lucation and one (1.6%) had
attained college level. Employment pattern showed 50% were c ivil servants, 30% were self
employed and 20% were unemployed. The duration of disease ranged from 1-24 weeks with
two peaks at two weeks and six weeks. Orthopaedic cases constituted 78.7% and general
surgery 21.3%. Preoperative haemoglobin ranged from 13.5-1 4.2 gtdl. Transfusions were
given intraoperatively to 41 (66.1 %) and to 12 (33.9%) postoperatively. Mean duration of
hospitalisation was 13 days (range 5 to 21 days). 98.4% deposited only one unit while 1.6%
deposited four units of blood. Only one patient required additional transfusion from
homologous donors.
Conclusion: The strategies and basis for autotransfusion have I teen demonstrated among a
majority of adult patients requiring orthopaedic procedures. Mi ljor determinants are shown
to be baseline blood count profdes and time to operation.
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