Prevalence and Factors Associated with Acute Blood Transfusion Reactions: A Cross-sectional Study in Southwest of Iran

Abstract

Background: Blood transfusion may lead to adverse events ranging in severity from minor to life-threatening. These events can occur during a transfusion, termed acute transfusion reactions (ATRs), or days to months later, and termed delayed transfusion reactions. Understanding the prevalence and factors associated with ATRs is essential for enhancing patient safety and optimizing transfusion practices. Objectives: The present study aimed to assess the prevalence of ATRs and identify associated factors among transfused patients in a teaching hospital over a two-year period. Methods: This retrospective cross-sectional study was designed based on the medical records of 36,595 transfused patients in a teaching hospital in southwestern Iran from 2020 to 2021. Inclusion criteria were patients who experienced ATRs, while exclusion criteria involved patients with ATRs but incomplete records. Demographic and clinical data were extracted from complication reporting forms. Data were analyzed using GraphPad Prism software version 8.3. The chi-square test was used to compare the correlation between reactions with or without a previous history of blood transfusion (P < 0.05). Results: In the total number of transfusions, the reaction rate was 0.3% (100 cases); 57% were men and 43% were women. The age range was 9 days to 89 years (mean age, 43.1 ± 20.8 years). The most common reaction was allergic (80%), followed by non-hemolytic febrile reactions (15%), anaphylaxis (2%), acute lung injury related to blood transfusion (2%), and volumetric overload (1%). A history of blood transfusion was noted in 52% of cases. No statistically significant relation was observed between the history of transfusion and transfusion reactions (P = 0.7). Conclusions: Allergic and febrile non-hemolytic reactions (FNHRs) were the most prevalent complications related to transfusions. The study indicated that the history of blood transfusions did not significantly trigger these reactions. Nurses should closely monitor patients for ATRs and ensure timely reporting of any reactions. The hemovigilance center of the hospital should analyze the prevalence of reactions and the frequency of each type of reaction to identify the sources of errors that may induce reactions and develop potential strategies for minimizing errors in future transfusions.