[The Clinical Characteristics and Influential Factors of Adverse Transfusion Reactions].

OBJECTIVE

To provide evidence for early prevention and ensure the safety of blood transfusion by analyzing the clinical characteristics and influential factors of patients with adverse transfusion reactions in our hospital.

METHODS

The information of patients with adverse transfusion reactions among all inpatients receiving blood transfusion from July 2021 to July 2023 in our hospital were collected. The types of adverse transfusion reactions, patients' characteristics, the time of transfusion reactions, the time of blood component leaving the blood bank were analyzed.

RESULTS

From July 2021 to July 2023, there were a total of 10 299 person-times of transfusion in our hospital, and adverse transfusion reactions occurred in 180 patients. The total incidence of adverse transfusion reactions was 1.75%, with allergic reactions accounting for 61.50% and non-hemolytic febrile transfusion reactions (NHFTR) accounting for 36.90%. The incidence of adverse transfusion reactions in blood components of apheresis platelet, plasma and suspended RBC was 4.85%, 2.57% and 0.85%, respectively (P < 0.001). In the patients with adverse transfusion reactions, the proportion of female patients was higher than that of male patients. The proportion of patients with previous history of blood transfusion was significantly higher than that of patients without history of blood transfusion. In the composition of blood group, the proportion of patients with type A was higher than that of patients with type AB. In the age composition of patients, patients aged 18-60 years accounted for the largest proportion, followed by the age group above 60 years old, while the smallest proportion was made up of those under 18 years old. The department distribution was mainly hematology, followed by infectious diseases, gastroenterology, nephrology and other departments. The NHFTR and allergic reaction were the highest within 3 hours after transfusion of RBC blood products. While the proportions of NHFTR and allergic reaction were the highest within 2 hours after transfusion of plasma and apheresis platelets. The incidence of adverse transfusion reactions between different types of blood components leaving the blood bank during the two time periods of 0-15 minutes and more than 15 minutes were compared. The results showed that the incidence of adverse transfusion reactions of suspended RBC products in the two time periods was 0.90% and 0.71%, respectively (P >0.05), After transfusion of plasma blood products, the incidence of adverse transfusion reactions in the two time periods was 1.74% and 3.19%, respectively (P < 0.05). The incidence of adverse transfusion reactions of apheresis platelets in the two time periods was 4.15% and 6.49%, respectively (P >0.05).

CONCLUSION

The main influencing factors of adverse transfusion reactions include the type of blood products, the time of blood leaving the blood bank, gender, blood transfusion history, blood type, age, and disease type. The high-incidence period of adverse transfusion reactions with different types of blood products is different, so targeted monitoring is crucial for transfusion safety.