Analyzing real world data of blood transfusion adverse events: Opportunities and challenges

Abstract

Background: Blood transfusions are a vital component of modern healthcare, yet adverse reactions to blood product transfusions can cause morbidity, and rarely result in mortality. Therefore, accurate reporting of transfusion related adverse events (TRAEs) is paramount to improved transfusion practice. This study aims to investigate real-world data (RWD) on TRAEs by evaluating differences between ICD 9/10-based electronic health records (EHR) and blood bank-specific reporting.Study Design and Methods: TRAE data were retrospectively collected from a blood bank-specific database between Jan 2015 and June 2019 as the reference data source and compared it to ICD 9/10 diagnostic codes corresponding to various TRAEs. Seven reactions that have corresponding ICD 9/10 diagnostic codes were evaluated: Transfusion related circulatory overload (TACO), transfusion related acute lung injury (TRALI), febrile non-hemolytic reaction (FNHTR), transfusion-related anaphylactic reaction (TRA), acute hemolytic transfusion reaction (AHTR), delayed hemolytic transfusion reaction (DHTR), and delayed serologic reaction (DSTR). These accounted for 33% of the TRAEs at an academic institution during the study period.Results: Among 18637 adult blood transfusion recipients, there were 229 unique patients with 263 TRAE related ICD codes in the EHR, while there were 191 unique patients with 287 TRAEs identified in the blood bank database. None of the categories of reaction we investigated had perfect alignment between ICD 9/10 codes and blood bank specific diagnoses.Discussion: Multiple systemic challenges were identified that hinder effective reporting of TRAEs. Identifying factors causing inconsistent reporting between blood banks and EHRs is paramount to developing effective workability between these electronic systems, as well as across clinical and laboratory teams.blood transfusions, electronic health records, transfusion related adverse events This article's contents reflect the views of the authors and should not be construed to represent FDA's official views or policies.

Analysis of Factors Influencing the Effect of Red Blood Cell Suspension Infusion in Children

“…It may also be related to the high metabolic state of the body [12]. Most of the posttransfusion fever reported in the literature is based on the febrile non-hemolytic blood transfusion reaction among the adverse reactions of blood transfusion, and the body temperature within 4 hours after the cessation of blood transfusion Open Journal of Internal Medicine is more than 38˚C, at the same time, it is more than 1˚C higher than that before blood transfusion, or the patient has chills, and there are no other factors to explain it [13]. The difference is that the fever after blood transfusion in this study is defined as the body temperature greater than 37.3˚C, and the statistical results…”

Perioperative Considerations in Management of the Severely Bleeding Coagulopathic Patient

“…132 Severe side effects, such as transfusion-related acute lung injury and transfusion-associated circulatory overload, are described. 133 However, data for the efficacy and safety of this widely used practice and guideline recommended intervention are scant and diluted by the large proportion of studies with prophylactic FFP transfusions. 134,135 Particularly in trauma, there is an ongoing debate about the use of fresh whole blood transfused within 24 h of donation, a strategy originating mainly in military medicine.…”

Aspectos generales de Lesión Pulmonar aguda producida por transfusión sanguínea o TRALI.

“…Ante esos resultados, similares a los obtenidos en otras investigaciones, se nota la necesidad de brindar mayor capacitación a las personas que acompañan a los pacientes durante la transfusión, acerca de la importancia del reporte de cualquier evento, así como brindar conocimiento de las diferentes reacciones adversas como consecuencia de una transfusión sanguínea. Ese aumento en las facultades de este personal es fundamental para disminuir ese subregistro, lo que permitiría obtener información valiosa oportunamente, llevando a una mejora en el diagnóstico preciso de cada evento y una mejor atención a los pacientes que los experimenten luego de una transfusión (18). Una de las principales causas del bajo registro de estos casos lo constituye el hecho que, por muchos años, hubo poco consenso en la definición del cuadro y sus manifestaciones.…”

“…Por otro lado, existe evidencia de factores genéticos que también constituyen factores de riesgo, específicamente de mutaciones asociadas con proteínas inflamatorias como la enzima convertidora de angiotensina (18).…”

“…En Europa se ha informado inclusive una menor incidencia, oscilando alrededor de 1 caso por cada 29,000-270,000 unidades transfundidas(5,16,17).En un estudio reciente llevado a cabo por Investigadores de la Universidad de Stanford, Estados Unidos, muestra datos que son de mucho interés, no solo a la hora de establecer la incidencia de estos eventos, sino en la construcción de herramientas que puedan conformar un sistema de información, notificación y prevención de estos. Se encontraron discrepancias cuando contrastaron el reporte de estos eventos en la base de datos de pacientes del Hospital Universitario versus los que fueron informados a la base de datos del Banco de Sangre, y entre la dos anteriores y los que finalmente fueron confirmados por el equipo de medicina transfusional, además, quedó demostrado un subregistro de eventos pos-transfusionales en la base de datos de los pacientes incluso después de que se contase con un diagnóstico confirmado y se haya realizado la debida comunicación de los mismos por parte del equipo de medicina transfusional(18).2022 Antony Orozco Barquero. vol 6, número 6 Diciembre 2022-Enero 2023 DOI: doi.org/10.34192/cienciaysalud.v6i6.534…”