| Research backgroundBlood transfusion is one of the most important methods in clinical treatment and part of the modern healthcare. The effective supply of blood and blood components is an important guarantee of the normal operation of hospitals, which includes many aspects, such as massive transfusion in operations, transfusion in emergency treatment, clinical treatment effect and medical safety. Since the pass of Blood Donation Act in1998, volunteer blood donation and clinical blood use in China have been managed according to laws, and all the blood used in clinical treatment is donated voluntarily. With the improvement of China’s healthcare and social medical insurance system, clinical need for blood and blood components is growing rapidly. Blood is a special product. Based on serology and the preservation features of blood and blood components, especially red blood cells and blood platelets, which can only be kept for several days to several weeks. The uncertainty and randomness of the quantity and time of the blood needed will lead to inadequate preparation of the quantity and type of blood components. The collection, test, manufacture of blood and the complexity of blood type will also affect the efficient supply of blood. Temporary blood collection will not meet the need of emergency treatment and massive transfusion in operations. Therefore, it has great social importance and economic benefit to determine effective blood dynamic inventory through studies and take measures to insure adequate blood and avoid waste by excessive inventory.Research objective Total quantity of blood transfusion and blood components were analyzed through the blood transfusion data in Jinan from2003to2012. Based on the characteristics with different hospitals, including medical resources, treatment level, location, service objectives, hospitals with different levels, types and professional features were dynamically analyzed to find the dynamic change rules of blood collection and supply in Jinan and built an effective prediction model, thus to directivolunteer blood donation, blood inventory and resources allocation, and develp adequate, reasonable and effective blood collection and supply measures.Materials and methodsThis research built the database and conducted a general statistical analysis on volunteer blood donation, clinical blood and blood components in Jinan blood station from2003to2012, including volunteer donors, clinical blood and blood components, such as red blood cells in additive solution leukocytes reduced, washed red blood cells, deglycerolized red blood cells, frozen plasma methylene blue treated and removed, apheresis platelets leukocytes reduced, cryoprecipitated antihemophilic factor. Based on the general statistical analysis and with the method of time series analysis, the author selected the clinical blood supply of Ji’nan city Central Hospital and the clinical use data of A、B、O、AB type red blood cells in additive solution leukocytes reduced and apheresis platelets leukocytes reduced from2007to2011to predict the clinical blood need and prove with a prediction model, aiming at instructing blood inventory and guiding volunteer blood donation.Research resultsBlood collection and supply in Jinan is a dynamic balance with a tendency of growing year by year, and clinical blood supply is also growing each year. The supply of all blood components except for whole blood lekocytes reduced is growing,the single largest rise in apheresis platelets leukocytes reduced is43.92%. Blood supply prediction models based on the clinical use of the most respresentative red blood cells in additive solution leukocytes reduced、apheresis platelets leukocytes reduced and the clinical blood supply of Ji’nan city Central Hospital as follows: red blood cells in additive solution leukocytes reduced: The model of type A red blood cells in additive solution leukocytes reduced is ARMA (5,0): Ai=997.4865+0.17791×A(l-1)-0.07155×A(1-2)+0.40431×A(1-3)+0.29504×A(i-4)+0.19428×A(1-5)The model of type B red blood cells in additive solution leukocytes reduced is ARMA (1,1): Bi=1088.743+1×B(i-1)+0.77315×ε(l-1)The model of type O red blood cells in additive solution leukocytes reduced is ARMA (4,1): Oi=1198.895-0.3486×O(i-1)+0.43843×O(i-2)+0.16766×O(i-3)+0.38064×O(i-4)-0.75513×ε(i-1)The model of type AB red blood cells in additive soluton leukocytes reduced is ARMA(2,0): ABi=375.9115+0.31687×AB(i-1)+0.29675×AB(i-2) apheresis platelets leukocytes reduced:The model of type A apheresis platelets leukocytes reduced is ARMA(1,0): Ai=35.21645+0.44359×A(i-1)The model of type B apheresis platelets leukocytes reduced is ARMA(1,1): Bi=35.70846+1×B(i-1)+0.66915×ε(i-1)The model of type O apheresis platelets leukocytes reduced is ARMA(1,1): Oi=20.45938+1×O(i-1)+0.6315×ε(i-1)The model of type AB apheresis platelets leukocytes reduced is ARMA(1,2): ABi=8.41516+1×AB(i-1)+0.57811×ε(i-1)+0.2453×ε(i-2)The model of Ji’nan city Central Hospital clinical blood supply is ARMA(4,0): Yi=866.1631+0.46805×Y(i-1)+0.05572×Y(i-2)+0.12379×Y(i-3)+0.35244×Y(i-4)Research conclusionClinical consumption of all blood components in Jinan keeps growing yearly.The hospital according to their clinical features, clinical use of blood have their own characteristics; The established prediction model of clinical consumption each suspended red blood cells in additive solution leukocytes reduced can reflect the variety regulation of time series more scientifically and objectively and can be used to predict the clinical blood demand in Jinan,and provide the basis for establishing reasonable and effective blood reserves. |
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