Surreal illustration of blood cells in surgery, representing balanced resource management.

Blood Transfusions: Are Elective Surgeries in Korea Getting Smarter?

Samir D’Costa in Health & Wellness December 2025 • 4 min read.

"A new study reveals trends in red blood cell (RBC) transfusions during elective surgeries in Korea, highlighting both progress and areas for improvement in blood management practices."

Red blood cell (RBC) transfusions are a critical part of modern medicine, often serving as a lifeline for patients experiencing blood loss during surgery. While these transfusions can be life-saving, they also carry risks, including adverse reactions and complications. Given that blood products are a limited and valuable resource, hospitals and healthcare systems are constantly seeking ways to optimize their use, balancing patient safety with cost-effectiveness.

A recent study delved into the trends of RBC transfusions in elective surgeries in Korea over a 12-year span, from 2002 to 2013. By analyzing data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC), researchers aimed to understand how transfusion practices have evolved and identify areas for potential improvement.

This article breaks down the key findings of this study, explaining what they mean for patients, healthcare providers, and the future of blood management in surgical settings. We'll explore the factors influencing transfusion rates, the types of surgeries most commonly associated with RBC use, and the ongoing efforts to ensure blood products are used wisely and efficiently.

Key Trends in RBC Transfusions: What the Data Reveals

Surreal illustration of blood cells in surgery, representing balanced resource management.

The study, encompassing data from 487,238 cases across 206 selected surgical operations, revealed that RBC units were used in 8.1% of cases. Overall, 60,815 RBC units were transfused, averaging 0.13 units per patient. For those who received transfusions, the average was 1.53 units per case. The data also highlighted some key demographic trends:

Gender: Females received 56.7% of the transfused RBC units.
Age: Patients aged 60 and older accounted for 60.1% of RBC unit transfusions.
Surgery Type: Orthopedic surgeries led in RBC unit usage (33.8%), followed by general surgeries (12.0%) and vascular surgeries (11.8%).

Notably, the number of operations performed within the cohort increased from 27,690 in 2002 to 49,473 in 2013, and the mean number of RBC units used per operation also rose from 0.08 units in 2002 to 0.15 units in 2013. These numbers point toward a greater overall demand for blood transfusions in elective surgical settings over the studied period.

The Path Forward: Optimizing Blood Transfusion Practices

The study underscores the importance of continuous management of blood preparation and transfusion practices to ensure the efficient use of this valuable resource. Regular nationwide investigations into blood product usage can provide data applicable to blood product preparation for various elective surgical operations.

One key strategy for optimizing blood use is the implementation of Maximum Surgical Blood Order Schedules (MSBOS), which provide guidelines for the maximum number of RBC units to prepare for specific elective surgeries. These schedules, combined with type and screen (T&S) methods, can help reduce unnecessary blood preparation and minimize waste.

Ultimately, by embracing evidence-based practices, fostering collaboration between blood banks and clinicians, and prioritizing patient-centered care, healthcare systems can ensure that blood transfusions are used judiciously, improving patient outcomes and promoting the responsible stewardship of blood resources.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/trf.14839, Alternate LINK

Title: Analysis Of Red Blood Cell Use In Elective Surgeries Over 12 Years In Korea

Subject: Hematology

Journal: Transfusion

Publisher: Wiley

Authors: Banseok Kim, Yongjung Park, Young Ah Kim, Minjin Kang, Sinyoung Kim, Hyun Ok Kim

Published: 2018-09-12

Everything You Need To Know

What are red blood cell (RBC) transfusions and why is it important to manage them effectively during surgery?

Red blood cell (RBC) transfusions involve administering red blood cells to a patient, usually to compensate for blood loss during surgery or due to anemia. While RBC transfusions can be life-saving, they also pose risks, such as adverse reactions and complications. Therefore, hospitals aim to optimize their use, balancing patient safety with cost-effectiveness. The key is to administer RBC units only when medically necessary, reducing unnecessary exposure to potential risks and conserving a limited resource. Better blood management practices are essential to minimize these risks.

According to the Korean study, what percentage of elective surgery cases involved red blood cell (RBC) transfusions, and what was the average number of units used?

The study in Korea revealed that Red Blood Cell (RBC) units were used in 8.1% of elective surgery cases. On average, 0.13 RBC units were used per patient across all cases. However, for patients who did receive a transfusion, the average was 1.53 RBC units per case. This suggests that while many patients undergoing elective surgery don't require a transfusion, those who do typically receive more than one unit.

What key demographic and surgical trends were identified in the study regarding the use of red blood cell (RBC) transfusions?

The data indicated that females received 56.7% of the transfused RBC units, suggesting potential gender-related differences in transfusion needs or surgical procedures. Patients aged 60 and older accounted for 60.1% of RBC unit transfusions, reflecting the higher likelihood of age-related health issues requiring blood transfusions. Orthopedic surgeries led in RBC unit usage (33.8%), followed by general surgeries (12.0%) and vascular surgeries (11.8%). These differences highlight the importance of blood management in various specialties.

How did the overall demand for red blood cell (RBC) transfusions in elective surgical settings change between 2002 and 2013 in Korea, and what might explain this trend?

The number of operations performed increased from 27,690 in 2002 to 49,473 in 2013, and the mean number of RBC units used per operation also rose from 0.08 units in 2002 to 0.15 units in 2013. This increase suggests a growing demand for Red Blood Cell transfusions in elective surgical settings over the 12-year period. Several factors could explain this trend, including an aging population, changes in surgical practices, and evolving guidelines for transfusion thresholds. Understanding the specific drivers of this increase is crucial for effective blood management.

What steps can be taken to optimize red blood cell (RBC) transfusion practices and ensure the efficient use of this valuable resource?

Continuous management of blood preparation and transfusion practices is essential. Regular nationwide investigations into blood product usage can provide data applicable to blood product preparation for various elective surgical operations. This data can inform best practices, identify areas for improvement, and promote the efficient use of Red Blood Cell units. Implementing strategies such as patient blood management programs and restrictive transfusion guidelines can also help optimize blood usage and improve patient outcomes.