Blood Transfusion Complications and Associated Factors Among Blood-Transfused Adult Patients at Debre Markos Comprehensive Specialized Hospital, Ethiopia: A Cross Sectional Study

Abstract

Background

Blood transfusion is the infusion of whole blood or its components into the veins of the patient to improve tissue oxygenation and maintain hemostasis. Besides its clinical use, it can pose a risk of transfusion complications with different factors.

Purpose

The aim of this study was to assess blood transfusion complications, and associated factors among transfused adult patients at Debre Markos Comprehensive Specialized Hospital, North West Ethiopia, 2022.

Materials and Methods

An institution-based cross-sectional study design was conducted on a total of 182 patients from March 20 to June 15, 2022. Patients were enrolled in the study using consecutive sampling method. The socio-demographic and clinical data were collected using a structured questionnaire and data extraction sheet, respectively. About 3 ml of anti-coagulated blood and 30 ml of urine samples were collected to assess transfusion complications. CBC and Coombs test were performed from blood and urinalysis from urine, respectively. Chi-square, Fisher’s exact test, and binary logistic regression were done using SPSS version 25. P-values less than 0.05 are declared as statistically significant.

Results

An acute transfusion reaction (ATR) was encountered in 12 (6.6%) patients. It was 4.13, 7.78 and 3.96 times more likely to occur among patients with a previous history of transfusion, abortion, and transfused blood stored for more than 20 days compared to their counterparts, respectively. In addition, the odds of developing ATR increase by 2.07 as the number of transfused blood units increases by 1 unit.

Conclusion

The incidence of acute transfusion reactions was high. During transfusion, clinicians should closely monitor patients who had history of transfusion, abortion, transfused old blood and more than 1 unit.

Keywords:

• acute transfusion reactions
• adults
• transfusion outcome

Abbreviations

AHG, Anti-Human Globulin; AHTR, Acute Hemolytic Transfusion Reactions; ATR, Acute Transfusion Reaction; CBC, Complete Blood Count; DAT, Direct Anti-Globulin Test; DMCSH, Debre Markos Comprehensive Specialized Hospital; FFP, Fresh Frozen Plasma; FNHTR, Febrile Non-Hemolytic Transfusion Reaction; ICU, Intensive Care Unit; TACO, Transfusion Associated Circulatory Overload; TRALI, Transfusion Related Acute Lung Injury; WHO, World Health Organization.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable requests.

Ethical Approval and Informed Consent

This research was carried out in accordance with the Helsinki Declaration. Ethical approval was obtained from the School of Biomedical and Laboratory Sciences, Research Ethical Review Committee, College of Medicine and Health Sciences, University of Gondar (Reference number SBMLS/189/2014). Before recruitment, the aim, potential benefits, and risks of the study were explained to participants or their attendants. The written informed consent or assent was taken from volunteer participants or attendants, respectively. Furthermore, whenever a TRs or abnormal laboratory results occurred, the patient was linked to responsible health professionals to manage the problem.

Acknowledgments

We want to acknowledge DMCSH staff who helped during data collection. We also thank the study participants for their voluntary participation in the study.

Author Contributions

All authors made a significant contribution to the study reported whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation or all the areas: took part in drafting, revising, critically reviewing the article: gave final approval of the version to be published: have agreed on the journal to which the article to which the article has been submitted and agreed to accountable for all aspects of the work.

Disclosure

The authors declare no conflicts of interest in this work.

Additional information

Funding

No funded organization.