韩国一家三级护理医院非感染性输血不良反应的发生率及模式。

Frequency and pattern of noninfectious adverse transfusion reactions at a tertiary care hospital in Korea.

作者信息

Cho Jooyoung, Choi Seung Jun, Kim Sinyoung, Alghamdi Essam, Kim Hyun Ok

机构信息

Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.

Department of Laboratory Medicine, The Armed Forces Capital Hospital, Seongnam, Korea.

出版信息

Ann Lab Med. 2016 Jan;36(1):36-41. doi: 10.3343/alm.2016.36.1.36.

DOI:10.3343/alm.2016.36.1.36

PMID:26522757

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4697341/

Abstract

BACKGROUND

Although transfusion is a paramount life-saving therapy, there are multiple potential significant risks. Therefore, all adverse transfusion reaction (ATR) episodes require close monitoring. Using the computerized reporting system, we assessed the frequency and pattern of non-infectious ATRs.

METHODS

We analyzed two-year transfusion data from electronic medical records retrospectively. From March 2013 to February 2015, 364,569 units of blood were transfused. Of them, 334,582 (91.8%) records were identified from electronic nursing records. For the confirmation of ATRs by blood bank physicians, patients' electronic medical records were further evaluated.

RESULTS

According to the nursing records, the frequency of all possible transfusion-related events was 3.1%. After the blood bank physicians' review, the frequency was found to be 1.2%. The overall frequency of febrile non-hemolytic transfusion reactions (FNHTRs) to red blood cells (RBCs), platelet (PLT) components, and fresh frozen plasmas (FFPs) were 0.9%, 0.3%, and 0.2%, respectively, and allergic reactions represented 0.3% (RBCs), 0.9% (PLTs), and 0.9% (FFPs), respectively. The pre-storage leukocyte reduction significantly decreased the frequency of FNHTRs during the transfusion of RBCs (P<0.01) or PLTs (Pfalling dots0.01).

CONCLUSIONS

The frequency of FNHTRs, allergic reactions, and "no reactions" were 22.0%, 17.0%, and 60.7%, respectively. Leukocyte-reduction was associated with a lower rate of FNHTRs, but not with that of allergic reactions. The development of an effective electronic reporting system of ATRs is important in quantifying transfusion-related adverse events. This type of reporting system can also accurately identify the underlying problems and risk factors to further the quality of transfusion care for patients.

摘要

背景

尽管输血是一项至关重要的挽救生命的治疗方法，但存在多种潜在的重大风险。因此，所有输血不良反应（ATR）事件都需要密切监测。我们使用计算机化报告系统评估了非感染性 ATR 的发生频率和模式。

方法

我们回顾性分析了来自电子病历的两年输血数据。2013 年 3 月至 2015 年 2 月期间，共输注了 364,569 单位血液。其中，334,582（91.8%）条记录是从电子护理记录中识别出来的。为了让血库医生确认 ATR，对患者的电子病历进行了进一步评估。

结果

根据护理记录，所有可能的输血相关事件的发生率为 3.1%。经过血库医生的审查后，发现发生率为 1.2%。红细胞（RBC）、血小板（PLT）成分和新鲜冰冻血浆（FFP）的发热性非溶血性输血反应（FNHTR）的总体发生率分别为 0.9%、0.3%和 0.2%，过敏反应分别占 0.3%（RBC）、0.9%（PLT）和 0.9%（FFP）。储存前白细胞去除显著降低了 RBC（P<0.01）或 PLT（P<0.01）输血期间 FNHTR 的发生率。