Hematology Laboratory Unit of Jimma Medical Center, Jimma University, Jimma, Ethiopia.
School of Medical Laboratory Sciences, Jimma University, Jimma, Ethiopia.
PLoS One. 2021 Apr 26;16(4):e0250623. doi: 10.1371/journal.pone.0250623. eCollection 2021.
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.
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.
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.
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.
由于输血仍然是救命的手段，并且经常被开方使用，因此更多的输血是不必要或不适当的。这种重要的临床干预措施被报告为五种过度使用的医疗治疗方法之一，在发展中国家，大量的过度开方和全血输血是常见的。研究受血者的人口统计学特征、临床情况、适当的血液利用以及持续的临床审核，以确保质量保证和服务改进计划，是这一实践的重要因素。本研究旨在评估大型医疗中心受血者的特征、血型分布、输血的适宜性以及输血的利用情况。
本研究采用基于机构的横断面研究设计，时间为 2018 年 2 月 1 日至 6 月 30 日。使用为此研究准备的结构化数据收集格式收集数据。所有输血处方都从申请到完成进行了跟踪。收集了患者的年龄、性别、申请科室、血液动力学、申请和发放的单位数量以及输注的单位数量。通过基于标准的方法评估输血的适宜性，同时计算血液的利用情况。
在开具的 809 单位总血量中，共有 425 名患者的 545 个单位进行了交叉配型。接受输血的个体的平均和中位数年龄分别为 27.47 ±15.28 岁和 26 岁，65.4%是处于生育期的女性。观察到最常见的两种血型是 O 和 A 阳性血。总体而言，82.1%的输血是适宜的；然而，只有 27.8%的患者接受了适宜的成分输血，因为 96.5%的个体接受了全血输血。记录到显著的血液利用情况，C/T 比值为 1.05，TP%为 100%，TI 为 1.23。
大多数输血受血者相对年轻，女性居多，大多数处于生育期。尽管全血是唯一使用的成分，但记录到显著的血液输血利用和适宜性；然而，适宜的成分输血记录明显较低。需要制定当地的输血指南以及适当的成分准备和利用，以改善次优的血液成分输血实践。
