Investigating the Consumption, Return, and Waste of Blood and Blood Products by Clinical Groups and Type of Surgery, and Calculating International TI and C/T Indices in Al-Zahra Specialized and Subspecialty Hospital in 2023, Compared with AABB Global Standards

Abstract

Background: Blood product wastage is a global problem in hospitals. This study aimed to evaluate the consumption of blood products in Al-Zahra Hospital in 2023, focusing on blood use per surgery, return and waste rates, and the calculation of international TI and C/T indices. Methods: This study examined all hospitalized patients at Al-Zahra Hospital who received blood or blood products during this period using a census method. C/T index rates were calculated for these patients and compared with the AABB global standard. Findings: We studied 2,758 patients who required blood products. Platelets, cryoprecipitate, and apheresis platelets were rarely returned, indicating high demand and precise ordering practices. In contrast, packed cells and fresh frozen plasma (FFP) were frequently returned, indicating overestimation of need or a change in clinical demand. The C/T ratio remained consistently above 1 in all months, indicating that blood cross-matching exceeded transfusion demand throughout the year. Conclusion: Younger patients tended to receive whole blood and apheresis platelets, while older patients were more likely to receive packed cells and FFP. In general, women received a higher volume of blood products compared to men. C/T ratios in this study ranged from 1.05 to 1.30, which is within the acceptable range of the AABB standard. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.