Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
National Blood Transfusion Services, Dar es Salaam, Tanzania.
PLoS One. 2018 May 17;13(5):e0196453. doi: 10.1371/journal.pone.0196453. eCollection 2018.
Blood is a critical aspect of treatment in life saving situations, increasing demand. Blood requisition practices greatly effect sufficient supply in blood banks. This study aimed to determine the risk factors for inappropriate blood requisition in Tanzania.
This was a cross sectional study using secondary data of 14,460 patients' blood requests from 42 transfusion hospitals. Primary data were obtained by using cluster-sampling design. Data were analysed using a two-level mixed-effects Poisson regression to determine fixed-effects of individual-level factors and hospital level factors associated with inappropriate blood requests. P-value <0.05 (2-tails) was considered statistically significant.
Inappropriate requisition was 28.8%. Factors significantly associated with inappropriate requisition were; reporting pulse rate and capillary refill decrease the risk (RR 0.74; 95% CI 0.64, 0.84) and (RR 0.73; 95% CI 0.63, 0.85) respectively and the following increased the risk; having surgery during hospital stay (RR 1.22; 95% CI 1.06, 1.4); being in general surgical ward (RR 3.3; 95% CI 2.7, 4.2), paediatric ward (RR 1.8; 95% CI 1.2, 2.7), obstetric ward (RR 2.5; 95% CI 2.0, 3.1), gynaecological ward (RR 2.1; 95% CI 1.5, 2.9), orthopaedics ward (RR 3.8; 95% CI 2.2, 6.7). Age of the patient, pallor and confirmation of pre-transfusion haemoglobin level were also significantly associated with inappropriate requisition. Majority of appropriate requisitions within the wards were marked in internal medicine (91.7%) and gynaecological wards (77.8%).
The proportion of inappropriate blood requests was high. Blood requisition was determined by clinical and laboratory findings and the ward patients were admitted to. Adherence to transfusion guidelines is recommended to assure the best use of limited blood supply.
血液是拯救生命的治疗中至关重要的一环，其需求不断增加。血液采集的实践极大地影响了血库的充足供应。本研究旨在确定坦桑尼亚血液采集不当的风险因素。
这是一项使用来自 42 家输血医院的 14460 名患者血液请求的横断面研究。使用聚类抽样设计获得初级数据。使用两级混合效应泊松回归分析来确定与不适当的血液请求相关的个体水平因素和医院水平因素的固定效应。p 值<0.05（2 尾）被认为具有统计学意义。
不适当的采集率为 28.8%。与不适当采集显著相关的因素有：报告脉搏率和毛细血管再充盈减少风险（RR0.74；95%CI0.64，0.84）和（RR0.73；95%CI0.63，0.85），而以下因素增加了风险：住院期间手术（RR1.22；95%CI1.06，1.4）；在普通外科病房（RR3.3；95%CI2.7，4.2）、儿科病房（RR1.8；95%CI1.2，2.7）、产科病房（RR2.5；95%CI2.0，3.1）、妇科病房（RR2.1；95%CI1.5，2.9）、矫形外科病房（RR3.8；95%CI2.2，6.7）。患者年龄、苍白和输血前血红蛋白水平的确认也与不适当的采集显著相关。内科（91.7%）和妇科病房（77.8%）内的大多数适当采集都有标记。
不适当的血液请求比例很高。血液采集是由临床和实验室发现以及患者入院的病房决定的。建议遵守输血指南，以确保有限的血液供应得到最佳利用。
