Assessment of recipients’ characteristics, transfusion appropriateness, and utilization pattern of blood and blood products in Jimma Medical Center, Jimma, Ethiopia

Abstract

Background As blood transfusion remains life-saving and is being frequently prescribed, a greater number of its practice is unnecessary or inappropriate. This important clinical intervention is reported as one of the five overused medical treatments, with gross over-ordering and whole blood transfusions as the sole component being common in developing countries. Study of recipient’s demographics, clinical conditions, appropriate blood utilization, and continuous clinical audits for quality assurance and service improvement plan are important factors to this practice. This study was designed to assess the recipient’s characteristics, blood type distributions, appropriateness of blood transfusion, and utilization practice of the big medical center. Methods Institution based cross-sectional study was conducted from February 1 to June 30, 2018. Data were collected using a structured data collection format prepared for this study. All transfusion prescriptions were followed from requisition up to completion. Patient’s age, sex, requesting departments, hemodynamics, number and component of units requested and issued, and units transfused were collected. Transfusion appropriateness was assessed by a criterion-based method while blood utilization was calculated. Results A total of 545 units of blood for 425 patients were cross-matched of the 809 units of total blood prescribed. The mean and median age of transfused individuals was found to be 27.47 ±15.28 years and 26 years respectively, and 65.4% females most in reproductive age groups. O and A Rhesus-positive blood types were the two major blood groups observed. Overall 82.1% of transfusions were appropriate; while only 27.8% of patients received appropriate components as 96.5% of individuals received a whole blood transfusion. Significant blood utilization was recorded with a C/T ratio of 1.05, TP% of 100%, and TI of 1.23. Conclusion Much of the transfusion recipients were relatively young aged and females, most in the reproductive age group. Although whole blood was used as a sole component, significant blood transfusion utilization and appropriateness were recorded; while appropriate component transfusion was recorded to be significantly low. Local transfusion guidelines and appropriate component preparation and utilization are required to improve the sub-optimal blood component transfusion practice.

Assessment of Blood Transfusion Utilization and Patient Outcomes at Yekatit-12 Hospital, Addis Ababa, Ethiopia

“…In our study the overall ratios of cross-match to transfusion ratio (C/T), transfusion probability (%T), and transfusion index (TI) were 1.03, 99.8%, and 0.97, respectively ( Table 4 ); which indicates better utilization of blood units at different wards of Yekatit-12 Referral Hospital (C/T < 2.5%, T >30% and TI > 0.5). Similar to the current study findings; a study conducted in Jimma, Ethiopia, 10 in Gondar, Ethiopia, 7 in teaching hospitals of India, 15 and a study conducted in Northern India 16 were reported better utilization of blood units. However, the current study indicated a better utilization rate relative to a study conducted in Nigeria, 14 a cross-sectional study in Rajouri, 15 and a study conducted in the blood bank of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Nigeria.…”

“…In addition from a total of 1498 transfused blood units, most of the blood units; 1252 (83.6%) were RH positive and the rest 246 (16.4%) blood units were RH negative ( Table 1 ). This finding was in line with the findings of the study conducted at Tikur Anbessa Specialised Hospital, Ethiopia, 12 an institution-based cross-sectional study conducted in 2018 at Jimma, Ethiopia, 10 a cross-sectional study conducted at Gondar Hospital, Ethiopia, 7 year hospital-based study conducted in Black Lion Specialized Hospital, Ethiopia 13 and a study conducted in. 14 …”

“…Out of 615 transfused individuals; most of the patients were from the medical ward which accounts for 239 (38.9%), followed by the surgical ward which is 165 (26.8%) ( Table 6 ), and this finding was relatively in line with the finding of a study conducted by. 10 Whole blood was the abundantly transfused blood component (55.9% in a medical ward, 65.5% in the surgical ward, 79.2% in an emergency ward, 63.4% in gynecology wards, and 84.7% in other words) ( Table 3 ) which is in line with studies finding conducted in Ethiopia, 12 in Gondar, Ethiopia, 7 and BLSH, Ethiopia. 13 …”

“…In the current study, out of a total of 616 transfused patients, 328 (53.2%) were males and the mean age of the patients was 43 with a higher percentage in the age range 18–35 which accounts for 268 (43.5%) and this finding was similar with a study finding conducted in Gondar, 7 Nigeria 8 and the age group was somewhat higher with a study conducted in Jimma, Ethiopia. 9 A total of 1540 blood units were requested for 616 patients from different wards in Yekatit-12 Hospital from May 01 to July 30, 2021, of which 1498 (93.7%) blood units were transfused for each patient with a mean of 2.43 blood units which is relatively in line with the finding of different studies conducted in Gondar Hospital, Northwest Ethiopia, 7 higher relative to a study conducted in Jimma, Ethiopia, 10 Southern Nigeria, 8 Saudi Arabia 11 and lower than with a cross-sectional study conducted in Ethiopia. 12 From a total of 1498 blood units utilized; 990 (66.1%) were whole blood components, 709 (47.3%) of the blood transfused was blood group O type and 1252 (83.6%) of the blood was Rh-positive which is similar to the study conducted in Jimma, Ethiopia, 9 , 10 Southern Nigeria.…”

Profiles of Whole Blood Transfusion Recipients at a Teaching Hospital in Lahore, Pakistan

“…Females of the reproductive age group were predominant transfusion recipients at our hospital (68.8%). This observation is consistent with some previous studies [3,[5][6][7]. However, some of the previous literature reported males requiring more blood transfusion [8,9].…”