Proportion of Acute Transfusion Reaction and Associated Factors Among Adult Transfused Patients at Felege Hiwot Compressive Referral Hospital, Bahir Dar, Northwest Ethiopia: A Cross-Sectional Study

Abstract

Introduction

Acute transfusion reactions are adverse events occurring within 24 hrs of transfusion and cause simple-to-severe complications. They may vary with the blood component transfused and recipient factors. In Ethiopia, there is a limited evidence about the incidence and associated factors of transfusion reactions.

Objective

To determine the proportion of acute transfusion reactions and associated factors among adult transfused patients.

Methods

A total of 384 study participants were included in the study. Structured questionnaires were used for socio-demographic and past medical history data collection. Vital signs were measured as a baseline for every study participants and monitored and followed for 24 hrs. Laboratory tests like complete blood count, direct anti-human globulin test and urine hemoglobin were done as a baseline for suspected patients. Cross-match, blood grouping, and blood culture for patients and donors sample were also done for suspected patients. Descriptive statistics, bivariable and multivariable binary logistic regression were analyzed using SPSS version 20. P-value of <0.05 in the multivariable model was considered as statistically significant.

Results

Acute transfusion reactions were observed in 5.2% of patients. Of total cases of acute transfusion reaction, the majority developed allergic reactions (65%) and febrile non-hemolytic transfusion reaction (30%). It was significantly associated with transfusion history (AOR=3.4; 95% CI: 1.2–9.7), abortion history (AOR=5.0; 95% CI: 1.5–16.4), longer blood storage time (AOR=5.1; 95% CI: 1.7–15.2) and receiving three or more unit of blood (AOR= 4.1; 95% CI: 1.5–11.2).

Conclusion

Acute transfusion reactions were observed in 5.2% of patients (allergic reactions (65%), febrile non-hemolytic transfusion reaction (30%) and alloimmunization (5%)). Patients with a history of transfusion, abortion, transfused with blood stored ≥14 days and multi-transfused patients should be closely monitored.

Keywords:

• acute transfusion reaction
• adverse event
• blood transfusion
• transfusion reaction
• Ethiopia

Acknowledgments

We like to put our great full appreciation to the study participants and organizations: Amhara Regional State Health Bureau, Bahir Dar Blood Bank Service, Amhara Public Health Institute, Felege Hiwot Comprehensive Referral Hospital.

Abbreviations

AGH, antihuman globulin; AHTR, acute hemolytic transfusion reaction; AOR, adjusted odd ratio; ATR, acute transfusion reaction; BS, blood sepsis; CBC, complete blood count; COR, crude odd ratio; DAT, direct human anti-globulin test; FHCRH, Felege Hiwot Comprehensive Referral Hospital; FNHTR, febrile non-hemolytic transfusion reaction; Hb, hemoglobin; RBC, red blood cell; TACO, transfusion-associated cardiac overload; TRALI, transfusion-related acute lung injury.

Data Sharing Statement

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

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors have declared that no competing interests exist.

Additional information

Funding

There is no funding to report.