ENT compared to other surgical specialties
At a local level, ENT uses the least RBC units for transfusion when compared to other specialties. For example in 2018, ENT transfused a total of 38 units whilst other specialties such as haematological oncology (2957) and transplant (2266) utilised the most RBC units. When compared to other surgical specialities, trauma surgery (633) and vascular surgery (616) used the most units.10 This is also reflected in national data. For example in the 2014 national survey, cardiac surgery and trauma had the most units transfused in surgery while ENT only made up 0.5% of the total.5This disparity could be due to a different patient demographic and caseload in ENT. Choi et al. showed a young mean age of adults (50.3 years) presenting with ENT issues, which were predominantly managed with bedside procedures (66.7%) rather than surgical intervention (16.3%). Furthermore, he found only 29.2% of emergency presentations requiring hospitalisation.12 Conversely, patients undergoing cardiac surgery have higher rates of blood transfusions when compared to non-cardiac surgery patients, which is likely due to the patients having multiple co-morbidities including anaemia, diabetes mellitus, advanced heart and renal disease.13,14 Another reason could be due to the reduced cancer caseload within ENT when compared to other specialties. Head and Neck Cancer only accounts for 3% of cancer cases nationally, while breast, prostate, lung and bowel cancers together account for 53% of new cases.15