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Associated Factors With Acute Transfusion Reaction From Hospital Online Reporting Events

A Retrospective Cohort Study

Yao, Chao-Yuan MD*†; Chien, Ju-Huei PhD‡§; Chuang, Hsun-Yang MS; Ho, Tsing-Fen PhD

doi: 10.1097/PTS.0000000000000527
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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 (<5×103/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.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

From the *Department of Hematology and Oncology, Taichung Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, Taichung;

School of Medicine, Tzu-Chi University, Hualien;

Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung;

§Department of Laboratory Medicine, Taichung Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, Taichung; and

Department of Research, Taichung Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, Taichung, Taiwan.

Correspondence: Tsing-Fen Ho, PhD, Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, 666 Buzih Road, Beitun District, Taichung 40601, Taiwan (e-mail: tfho@ctust.edu.tw).

This work was supported by the Ministry of Science and Technology of Taiwan (MOST105-2313-B-166-001) and the Taichung Tzu-Chi Hospital, Taichung, Taiwan (TCCRD106-15 and CTU106-TTCH-001). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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