Blood transfusion indications, outcomes, complications, and associated factors among blood transfused adult patients at Debre Markos Comprehensive Specialized Hospital, North West Ethiopia

Abstract

ABSTRACT Background: Blood transfusion is the infusion of whole blood or its components into the veins of the patient for a variety of diseases to improve tissue oxygenation and maintain hemostasis. Besides its clinical use, it can pose a risk of transfusion complications, which may be associated with different factors. Objective: The main objective of the study was to assess blood transfusion indications, outcomes, complications, and associated factors among transfused adult patients at Debre Markos Comprehensive Specialized Hospital, North West Ethiopia, 2022. Methods: An institution-based cross-sectional study design with consecutive sampling techniques was conducted on a total of 236 transfused adult patients from March 20 to June 15, 2022. The socio-demographic and clinical data of the study participants were collected using a structured questionnaire and data extraction sheet, respectively. Three milliliters of anti-coagulated blood and 30 milliliters of urine samples were collected for laboratory analysis. Complete blood cell count, Coombs test, and urinalysis were performed to assess transfusion outcomes. Chi-square, Fisher's exact test, and binary logistic regression were done using SPSS version 25. P-values less than 0.05 declared as statistically significant. Results: Of the total 236 transfused patients, 50.42%, 38.56%, 6.78%, and 4.2% were indicated for acute anemia, acute blood loss, hematological disorders, and anemia with an unknown disease. About 81% (95% CI = 76%–86%) showed improvement. One hundred eighty two patients were not took anesthetic and transfusion reaction was encountered on 12 (6.6%, 95% CI = 3.3%–10.7%). Acute transfusion reaction was 4.13, 7.78, and 3.96 times more likely 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 and recommendations: The most common reasons for blood transfusion were acute and chronic anemia. The incidence of acute transfusion reactions was high. Patient age, number of transfused blood units, and previous transfusion had negative associations with posttransfusion improvement, whereas pre-transfusion hemoglobin and pre-transfusion stability were positive relation. During transfusion the clinicians should closely monitored patients who had history of transfusion, abortion, old blood transfused, multiunit transfused, aged patients, pre transfusion clinically instable patients, and low hemoglobin.