IntroductionPatients with hematologic malignancy have a higher risk of developing red blood cell (RBC) alloimmunization which can delay blood transfusion. Information on the risk factors for alloimmunization in this group is still limited. This study aimed to determine the prevalence and predictors of RBC alloimmunization among these patients.Materials and MethodsElectronic medical records of the patients with acute myeloid leukaemia (AML), acute lymphoid leukaemia (ALL), multiple myeloma (MM) and lymphoma from a tertiary care hospital between January 2018 and December 2022 were retrospectively reviewed. Clinical, demographic and transfusion history data of the included patients were analysed.ResultsOf the 983 patients with hematologic malignancy, 798 were included in the study. The prevalence of RBC alloantibodies in this population was 4.8% (38 patients). The alloimmunization rate of each subgroup was as followed: AML 9.1%, ALL 2.9%, MM 3.8% and lymphoma 2.5%. The most common alloantibodies were anti‐Mia, anti‐E and anti‐Lea. The majority (29/38, 76.3%) of alloimmunization had a single alloantibody. RBC autoantibody was detected in 10 patients. The detection of autoantibodies and having AML were independently associated with RBC alloimmunization (adjusted odds ratio [aOR] 13.41, 95% confidence interval [CI] 2.00–89.72, p = 0.007 and aOR 11.44, 95% CI 2.02–64.72, p = 0.006, respectively).ConclusionThe prevalence of RBC alloimmunization in the patients with hematologic malignancy was 4.8%. The alloimmunization rate of the AML subgroup was higher than those of other hematologic malignancies. The detection of autoantibodies and the AML diagnosis were identified as potential risk factors for RBC alloimmunization.
{"title":"Risk factors for red blood cell alloimmunization in patients with hematologic malignancy","authors":"Pakthipa Pattarakosol, Nattarat Lorucharoen, Phandee Watanaboonyongcharoen, Ponlapat Rojnuckarin","doi":"10.1111/tme.13096","DOIUrl":"https://doi.org/10.1111/tme.13096","url":null,"abstract":"IntroductionPatients with hematologic malignancy have a higher risk of developing red blood cell (RBC) alloimmunization which can delay blood transfusion. Information on the risk factors for alloimmunization in this group is still limited. This study aimed to determine the prevalence and predictors of RBC alloimmunization among these patients.Materials and MethodsElectronic medical records of the patients with acute myeloid leukaemia (AML), acute lymphoid leukaemia (ALL), multiple myeloma (MM) and lymphoma from a tertiary care hospital between January 2018 and December 2022 were retrospectively reviewed. Clinical, demographic and transfusion history data of the included patients were analysed.ResultsOf the 983 patients with hematologic malignancy, 798 were included in the study. The prevalence of RBC alloantibodies in this population was 4.8% (38 patients). The alloimmunization rate of each subgroup was as followed: AML 9.1%, ALL 2.9%, MM 3.8% and lymphoma 2.5%. The most common alloantibodies were anti‐Mi<jats:sup>a</jats:sup>, anti‐E and anti‐Le<jats:sup>a</jats:sup>. The majority (29/38, 76.3%) of alloimmunization had a single alloantibody. RBC autoantibody was detected in 10 patients. The detection of autoantibodies and having AML were independently associated with RBC alloimmunization (adjusted odds ratio [aOR] 13.41, 95% confidence interval [CI] 2.00–89.72, <jats:italic>p</jats:italic> = 0.007 and aOR 11.44, 95% CI 2.02–64.72, <jats:italic>p</jats:italic> = 0.006, respectively).ConclusionThe prevalence of RBC alloimmunization in the patients with hematologic malignancy was 4.8%. The alloimmunization rate of the AML subgroup was higher than those of other hematologic malignancies. The detection of autoantibodies and the AML diagnosis were identified as potential risk factors for RBC alloimmunization.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":"27 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BackgroundSevere transfusion reactions resulting from errors in matching the correct blood with the correct patient are considered never events. Despite the relative technical simplicity of barcode scanning for patient‐blood bag matching, the adoption and universal application of this safety measure are by no means universal. This study highlights the logistical and institutional challenges associated with spreading, scaling up, and sustaining such IT‐supported safety measures in healthcare.Study Design and MethodsWe report findings from a 5‐year, prospective, multi‐site case study conducted across one hospital in England and three hospitals in the Netherlands. Ethnographic methods, including interviews and observations, were used at each site to investigate the implementation of barcode scanning‐supported safety pathways for blood transfusions.ResultsSignificant variation was observed across the sites in the adoption and implementation of barcode scanning‐supported safety pathways. Despite the potential for reducing transfusion errors, the introduction of this innovation was met with varying levels of success in different settings.DiscussionThis study highlights the critical role of inter‐hospital learning and flexible system design in successfully implementing barcode scanning‐supported safety pathways for blood transfusions. A more structured, national‐level network for knowledge sharing could enhance the spread and sustainability of such innovations across healthcare settings.
{"title":"Implementation challenges of electronic blood transfusion safety systems: Lessons from an international, multi‐site comparative case study","authors":"Stijn Horck, Nick Fahy, Trisha Greenhalgh","doi":"10.1111/tme.13095","DOIUrl":"https://doi.org/10.1111/tme.13095","url":null,"abstract":"BackgroundSevere transfusion reactions resulting from errors in matching the correct blood with the correct patient are considered never events. Despite the relative technical simplicity of barcode scanning for patient‐blood bag matching, the adoption and universal application of this safety measure are by no means universal. This study highlights the logistical and institutional challenges associated with spreading, scaling up, and sustaining such IT‐supported safety measures in healthcare.Study Design and MethodsWe report findings from a 5‐year, prospective, multi‐site case study conducted across one hospital in England and three hospitals in the Netherlands. Ethnographic methods, including interviews and observations, were used at each site to investigate the implementation of barcode scanning‐supported safety pathways for blood transfusions.ResultsSignificant variation was observed across the sites in the adoption and implementation of barcode scanning‐supported safety pathways. Despite the potential for reducing transfusion errors, the introduction of this innovation was met with varying levels of success in different settings.DiscussionThis study highlights the critical role of inter‐hospital learning and flexible system design in successfully implementing barcode scanning‐supported safety pathways for blood transfusions. A more structured, national‐level network for knowledge sharing could enhance the spread and sustainability of such innovations across healthcare settings.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":"05 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chester A. Rosenthal, David J. Douin, Mitch J. Cohen, Julie A. Rizzo, Michael D. April, Steven G. Schauer
ObjectivesWe seek to describe the current practice pattern use of prothrombin complex concentrate (PCC) and fibrinogen concentrate (FC) in trauma patients.BackgroundTrauma‐induced coagulopathy (TIC) and endotheliopathy of trauma (EOT) contribute significantly to mortality from traumatic haemorrhage. FC, and 4‐factor PCC are potential treatments for EOT and TIC, respectively.Materials and MethodsWe obtained data from the Trauma Quality Improvement Program (TQIP) registry and identified patients who received either PCC or FC using procedural codes. We used descriptive statistics to characterise practice patterns of these products.ResultsThere were 6 714 002 total encounters within the TQIP from 2017 to 2022, of which 10 589 received PCC and 3009 received FC. Of the recipients, there were 35 that received both products. There were 44 that received both. The median age of PCC recipients was 77 (69–84) with 19 patients <15 years of age with the youngest being 2 years of age. There was a general upward trend in the number of facilities with documented use of PCC: 155/744, 168/766, 189/764, 206/780, 234/795, and 235/816, respectively. The median age of FC recipients was 57 (32–75) with 48 patients <15 years of age with the youngest being 1 year of age. There was a minor downward trend in the number of facilities that had documented use of FC: 55, 44, 39, 32, 38 and 40.ConclusionsThe administration of PCC and FC remains uncommon, although there appears to be an upward trend of PCC use. Most PCC use appeared to be for anticoagulation reversal in the setting of head trauma. Data guiding the use of these products are necessary as these products become more recognised as adjuncts to traumatic haemorrhage control.
{"title":"Characterising practice patterns of human derived, lyophilized coagulation concentrates within the trauma quality improvement program registry","authors":"Chester A. Rosenthal, David J. Douin, Mitch J. Cohen, Julie A. Rizzo, Michael D. April, Steven G. Schauer","doi":"10.1111/tme.13094","DOIUrl":"https://doi.org/10.1111/tme.13094","url":null,"abstract":"ObjectivesWe seek to describe the current practice pattern use of prothrombin complex concentrate (PCC) and fibrinogen concentrate (FC) in trauma patients.BackgroundTrauma‐induced coagulopathy (TIC) and endotheliopathy of trauma (EOT) contribute significantly to mortality from traumatic haemorrhage. FC, and 4‐factor PCC are potential treatments for EOT and TIC, respectively.Materials and MethodsWe obtained data from the Trauma Quality Improvement Program (TQIP) registry and identified patients who received either PCC or FC using procedural codes. We used descriptive statistics to characterise practice patterns of these products.ResultsThere were 6 714 002 total encounters within the TQIP from 2017 to 2022, of which 10 589 received PCC and 3009 received FC. Of the recipients, there were 35 that received both products. There were 44 that received both. The median age of PCC recipients was 77 (69–84) with 19 patients <15 years of age with the youngest being 2 years of age. There was a general upward trend in the number of facilities with documented use of PCC: 155/744, 168/766, 189/764, 206/780, 234/795, and 235/816, respectively. The median age of FC recipients was 57 (32–75) with 48 patients <15 years of age with the youngest being 1 year of age. There was a minor downward trend in the number of facilities that had documented use of FC: 55, 44, 39, 32, 38 and 40.ConclusionsThe administration of PCC and FC remains uncommon, although there appears to be an upward trend of PCC use. Most PCC use appeared to be for anticoagulation reversal in the setting of head trauma. Data guiding the use of these products are necessary as these products become more recognised as adjuncts to traumatic haemorrhage control.","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":"13 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：