Hospitalizations with blood transfusions and transfusion-related adverse events in US acute care hospitals, 2016-2020.

IF 2.5 3区 医学 Q2 HEMATOLOGY
Transfusion Pub Date : 2025-04-03 DOI:10.1111/trf.18229
Sophia V Kazakova, Opal L Reddy, Isabel Griffin, Lauri A Hicks, Ian Kracalik, Sridhar V Basavaraju
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引用次数: 0

Abstract

Background: National data on transfusion-related adverse events (TAEs) in the United States are limited. Administrative and payment-related data may augment hemovigilance systems to assess transfusion safety.

Study design and methods: A nationwide administrative database was analyzed to characterize transfusion-related hospitalizations and TAEs by trends, patient/hospital characteristics, and outcomes. Transfusions and TAEs were identified using medical codes and charges. Generalized estimating equations (GEE) modeled transfusion trends, while logistic regression assessed transfusion-associated circulatory overload (TACO) and transfusion-related acute lung injury (TRALI) risk factors.

Results: During 2016-2020, 8.4% of hospitalizations involved transfusions, with red blood cell (RBC) transfusion being most common (5.2%). In 2020, compared to 2016, hospitalizations with RBC transfusion decreased by 2% (Rate Ratio (RR) 0.98; 95% CI: 0.97-0.99), while plasma transfusion hospitalizations increased by 13% (RR 1.13; 95% CI: 1.08-1.19). TAEs occurred in 0.35% of hospitalizations (3.5/1000 transfusion hospitalizations). Among the TAEs included in the study, TACO, febrile nonhemolytic reactions, and TRALI were most common. In 27% of cases, the specific TAE was unidentified. TAEs were associated with higher inpatient mortality and longer lengths of stay. Variability in TAE rates was observed by patient and hospital characteristics. Risk factors for TACO included age >64, female sex, teaching hospitals, rural location, and Northeast region. TRALI risk was higher in teaching hospitals and those with >200 beds.

Conclusion: Administrative data provide insights into transfusion practices and associated morbidity and mortality but have limitations. Linking administrative, electronic health record, and blood bank data may enhance TAE identification.

2016-2020年美国急症医院输血住院和输血相关不良事件
背景:美国输血相关不良事件(TAEs)的国家数据有限。行政和支付相关的数据可以增强血液警戒系统来评估输血安全。研究设计和方法:分析了一个全国性的行政数据库,通过趋势、患者/医院特征和结果来描述与输血相关的住院和TAEs。输血和TAEs使用医疗代码和收费进行识别。广义估计方程(GEE)模拟了输血趋势,而逻辑回归评估了输血相关循环负荷(TACO)和输血相关急性肺损伤(TRALI)的危险因素。结果:2016-2020年期间,8.4%的住院病例涉及输血,其中红细胞(RBC)输血最为常见(5.2%)。与2016年相比,2020年因输血而住院的人数减少了2%(比率比(RR) 0.98;95% CI: 0.97-0.99),而输血住院率增加了13% (RR 1.13;95% ci: 1.08-1.19)。住院患者中有0.35%(每1000例输血住院患者中有3.5例发生TAEs)。在纳入研究的TAEs中,TACO、发热性非溶血反应和TRALI最为常见。在27%的病例中,具体的TAE不明。TAEs与更高的住院死亡率和更长的住院时间有关。根据患者和医院的特点观察到TAE发生率的变异性。发生TACO的危险因素包括年龄0 ~ 64岁、女性、教学医院、农村地区和东北地区。教学医院和拥有200张床位的医院的tri风险较高。结论:行政数据提供了输血实践和相关发病率和死亡率的见解,但有局限性。将行政管理、电子健康记录和血库数据联系起来可以增强TAE的识别。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Transfusion
Transfusion 医学-血液学
CiteScore
4.70
自引率
20.70%
发文量
426
审稿时长
1 months
期刊介绍: TRANSFUSION is the foremost publication in the world for new information regarding transfusion medicine. Written by and for members of AABB and other health-care workers, TRANSFUSION reports on the latest technical advances, discusses opposing viewpoints regarding controversial issues, and presents key conference proceedings. In addition to blood banking and transfusion medicine topics, TRANSFUSION presents submissions concerning patient blood management, tissue transplantation and hematopoietic, cellular, and gene therapies.
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