Associated Factors With Acute Transfusion Reaction From Hospital Online Reporting Events: A Retrospective Cohort Study

Abstract

Objectives In our hospital’s hemovigilance system, a Wi-Fi–based vital signs monitor that automatically transmits data to ensure patient safety has been implemented. We derived the potential clinical characteristics for subsequent association of acute transfusion reactions (ATRs) using the hospital information system database. Methods We retrospectively analyzed multiple factors to identify the possible associations between clinical factors and developing ATRs. The following data were collected: recipient’s pretransfusion and posttransfusion vital signs, clinical and laboratory characteristics, and presence of ATRs. Results In all, 44,691 events were analyzed. Of these, ATR events occurred in 1586 (3.5%). Logistic regression analysis revealed that leukopenia (<5×10 3 /μL) before transfusion was shown a statistically associated with developing mild ATRs (odds ratio [OR] = 2.38, 95% confidence interval [CI] = 1.68–3.35, P < 0.001). The association between elevated body temperature (forehead temperature > 37.5°C) and moderate ATRs was significant (OR = 1.55, 95% CI = 1.22–1.98, P < 0.001). In addition, the association between high diastolic pressure (>90 mm Hg) and severe ATRs was significant (OR = 1.78, 95% CI = 1.06–2.99, P = 0.03). Therefore, evaluated patient’s status such as vital signs before transfusion is very important. In addition, every hospital should established a complete hemovigilance program focus on effectively reporting and real-time monitoring ATRs to improve transfusion patient safety. Conclusions Vital signs monitoring and leukocyte counts before transfusion were significantly associated with the subsequent risk of ATRs. When patients with elevated body temperature, leukopenia, and high diastolic pressure who are scheduled to receive transfusion, clinicians should be aware of increasing the risk of ATRs in these patients.

Blood Transfusion Complications and Associated Factors Among Blood-Transfused Adult Patients at Debre Markos Comprehensive Specialized Hospital, Ethiopia: A Cross Sectional Study

“…5 , 6 In this study, the incidence of ATR was encountered in 12 patients (6.6%) (95% CI: 3.3–10.7%). This result was in line with previous studies conducted in Bahir Dar, Ethiopia (5.2%), 8 Bangladesh (3.6%), 19 Sweden (7.9%), 27 Tzu-Chi Hospital, Taiwan (3.5%), 24 Belgaum (4.4), 28 Kano, and North-Western Nigeria (3.6%). 29 The result of this study was higher than studies conducted in Iran (0.95), 18 India (0.96%), 1 Namibia (0.2%), 21 Bangalore, India (0.5%), 17 and Democratic Republic of Congo 2.6.…”

“…Furthermore, factors influencing blood transfusion outcome or complications include abortion history, vital signs, transfused blood component, and the number of transfused units. 8 , 24 To summarize, there was variation in blood component transfusion and ATR across the world. In Ethiopia, there is no hemovigilance system, and whole blood is the most commonly transfused blood.…”

Applying Healthcare Failure Mode and Effect Analysis and the Development of a Real-Time Mobile Application for Modified Early Warning Score Notification to Improve Patient Safety During Hemodialysis

“…Since 2010, a wireless vital signs monitoring system (Dinamap ProCare 300 Vital Signs Monitor [GE Medical Systems, Information Technologies, Inc, Milwaukee, WI]) has been integrated into our HIS. 14 The team + mobile application (version 1.8.5.0, designed by team + technology, Taiwan) was used for MEWS scoring (Table 1 ) for real-time warning and notification to physicians and nurses in charge to check patient condition. A total MEWS of 5 or higher indicated that the patient may be at risk of clinical deterioration and may require intensive care.…”

Improving our reaction time – Using technology to identify transfusion reactions sooner

“…A group in China reported the successful use of wireless monitoring in patients receiving transfusion. 31 Combining this monitoring of vitals with wearable technology is being pursued to allow better patient flow. The technology appears to be robust, and use is spreading, closing the gap on documentation delay.…”

“…Notably, dashboards can be viewed anywhere on a web browser. A group in China reported the successful use of wireless monitoring in patients receiving transfusion 31 . Combining this monitoring of vitals with wearable technology is being pursued to allow better patient flow.…”