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