Vossoughi Sarah, Parker-Jones Sylvia, Schwartz Joseph, Stotler Brie
Department of Pathology, Columbia University Irving Medical Center, New York, NY, USA.
Department of Transfusion Medicine, New York-Presbyterian Hospital, New York, NY, USA.
Vox Sang. 2019 Apr;114(3):232-236. doi: 10.1111/vox.12758. Epub 2019 Feb 7.
Passive transfusion reaction reporting systems fail to capture a significant number of reactions, and no data exist on provider reporting trends. The aim of this study was to describe transfusion reaction reporting patterns by adult and paediatric providers.
This is a multihospital study on transfusion reaction reporting over a 7-year period. Reports were categorized according to transfusion location and assigned to either a transfusion reaction or nonreaction group according to Centers for Disease Control imputability guidelines. Included in the reaction group (RXN) were definite, probable or possible reaction categories; with the remainder assigned as nonreactions (NORXN). Rates were calculated per 100,000 components transfused using chi-square comparison.
There were 1092 reports generated from 363 437 transfusions; 230 reports from 69 311 paediatric and 862 reports from 294 126 adult treatment areas. The reporting rate per 100 000 components transfused was 332 for paediatric and 293 for adult (P = 0·09). The per 100 000 components transfused rates were as follows: 237 for paediatric and 169 for adult (P < 0·01) in the RXN group; with 95 paediatric and 124 adult rates in the NORXN group (P = 0·04).
The total number of reports generated by paediatric and adult providers was not significantly different, suggesting that both provider groups engage the passive reporting system equally. However, paediatric providers reported more true reactions compared to adult providers. Robust hemovigilance systems will further the understanding of these trends and may aid in the development of targeted provider education programmes.
被动输血反应报告系统未能涵盖大量反应,且尚无关于医疗机构报告趋势的数据。本研究旨在描述成人和儿科医疗机构的输血反应报告模式。
这是一项为期7年的多医院输血反应报告研究。报告根据输血地点进行分类,并根据疾病控制中心的归因指南分为输血反应组或无反应组。反应组(RXN)包括明确、可能或疑似反应类别;其余则归类为无反应(NORXN)。使用卡方比较法计算每100,000次输注成分的发生率。
在363437次输血中产生了1092份报告;儿科治疗区域69311次输血产生230份报告,成人治疗区域294126次输血产生862份报告。每100,000次输注成分的报告率儿科为332,成人为293(P = 0.09)。每100,000次输注成分的发生率如下:反应组中儿科为237,成人为169(P < 0.01);无反应组中儿科为95,成人为124(P = 0.04)。
儿科和成人医疗机构产生的报告总数无显著差异,表明两组医疗机构对被动报告系统的参与程度相同。然而,与成人医疗机构相比,儿科医疗机构报告的真正反应更多。强大的血液监测系统将有助于进一步了解这些趋势,并可能有助于制定针对性的医疗机构教育计划。