Mortality and its associated factors in transfused patients at a tertiary hospital in Uganda

Okello, Clement Dove; Shih, Andrew W.; Angucia, B.S.; Kiwanuka, Noah; Heddle, Nancy M.; Orem, Jackson; Mayanja‐Kizza, Harriet

doi:10.1371/journal.pone.0275126

Cited by 4 publications

(7 citation statements)

References 38 publications

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“…61% of the 507 patients who received blood transfusions in the study by Waiswa et al [12] were male, whereas 39% were female. In the study by Okello et al [13] on patients aged 28 to 54 years, 55% of the transfused patients in 2012 were female. According to the literature, 175 (46.6%) of 368 patients in our study were male.…”

Section: Discussionmentioning

confidence: 97%

“…When the Hb value of patients falls below 8 g/dL in general, ES transfusion is frequently performed at higher levels in surgical patients [13,16]. In the CRIT study, it was shown that 45% of the patients received 5U or more ES transfusions, an average of 4.6±4.9U ES was given, and the amount of blood transfused and clinical survival were independent factors [27].…”

Section: Discussionmentioning

confidence: 99%

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Comprehensive Evaluation of Blood Product Transfusions Administered in the Emergency Department

Seçkin¹,

Coşkun²,

Demirci³

et al. 2023

globecc

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Objective: It was aimed to evaluate the clinical and laboratory findings, the frequency and distribution of post-transfusion complications of patients who presented to the emergency department with a transfusion indication. Materials and Methods:In our study, patients aged 18 years and over who applied to the emergency medicine clinic between January 01, 2019 and March 31, 2019, who had blood and blood product transfusions, were retrospectively analyzed. The demographic and clinical characteristics of the patients, the reason for transfusion, the number of transfused blood products, the presence and type of complications were analyzed.Results: Three hundred and sixty-eight patients who received blood and blood product transfusions were included in the study. The mean age of the patients was 62.5±19.3 years (range 18-96 years), 193 (52.4%) were female and 175 (47.6%) were male. The most common causes of transfusion were symptomatic anemia in 110 patients (29.9%), oncological diseases in 71 patients (19.3%), gastrointestinal bleeding in 65 patients (17.7%), and chronic renal failure patients in 59 (16%) patients. No post-transfusion complication was observed in 358 (97.3%) patients for all blood products. Multiple erythrocyte suspension (ES) data revealed significant variation in hemoglobin and hematocrit levels among patients (p=0.001). Additionally, a significant difference was found in the international normalized ratio because of administering more than one unit of fresh frozen plasma (FFP) (p=0.002). Complications were observed in 2.9% of patients given ES and 1.9% of patients given FFP, whereas none of the patients given thrombocyte suspension developed. Conclusion:The appropriate use of blood and blood products in the emergency department plays a critical role in preventing patient morbidity and mortality. Performing the transfusion procedure in the correct indication is important in preventing the risk of infection in the emergency department.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Comprehensive Evaluation of Blood Product Transfusions Administered in the Emergency Department

Seçkin¹,

Coşkun²,

Demirci³

et al. 2023

globecc

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“…Although transfusion with leucoreduced blood has been associated with some beneficial outcomes [ 2 – 10 ], these evidence have not been demonstrated in SSA. Recently, we reported the 30-day mortality rate in transfused patients in a tertiary hospital in Uganda to be 25.2%, where cancer was a top indication for transfusion [ 16 ]. Cancer was also the top indication for transfusion in an earlier study in Uganda [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

A randomized control trial to compare mortality in recipients of leucoreduced and non-leucoreduced whole blood transfusion in patients with cancer in Uganda

Okello,

Orem,

Nabwana

et al. 2024

BMC Cancer

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Background Mortality benefit of transfusion with leucoreduced whole blood has not been demonstrated in the sub-Saharan Africa (SSA). We compared mortality in patients with cancer transfused with leucoreduced and non-leucoreduced whole blood in a SSA setting. Methods An open-label randomized controlled trial was conducted at the Uganda Cancer Institute where participants were randomized in a 1:1 ratio into the leucoreduced and non-leucoreduced whole blood transfusion arms. Leucocyte filtration of whole blood was performed within 72 h of blood collection. Patients aged ≥ 15 years who were prescribed blood transfusion by the primary physicians were eligible for study enrolment. Mortality difference was analyzed using intention-to-treat survival analysis and cox proportional hazard model was used to analyze factors associated with mortality. Results There were 137 participants randomized to the leucoreduced and 140 to the non-leucoreduced arms. Baseline characteristics were similar between the two arms. The median number of blood transfusions received was 1 (IQR, 1–3) unit and 2 (IQR, 1–3) units in the leucoreduced and non-leucoreduced arms respectively, p = 0.07. The 30-day mortality rate in the leucoreduced arm was 4.6% (95% CI, 2.1–10) and was 6.2% (95% CI, 3.2–12.1) in the non-leucoreduced arm (p = 0.57), representing an absolute effect size of only 1.6%. Increasing age (HR = 0.92, 95% CI, 0.86–0.98, p = 0.02) and Eastern Co-operative Oncology Group (ECOG) performance score of 1 (HR = 0.03, 95% CI, 0.00–0.31, p < 0.01) were associated with reduced 30-day mortality. Conclusions The study failed to demonstrate mortality difference between cancer patients transfused with leucoreduced and non-leucoreduced whole blood. Although this study does not support nor refute universal leucoreduction to reduce mortality in patients with cancer in SSA, it demonstrates the feasibility of doing transfusion RCTs in Uganda, where a multi-center trial with an appropriate sample size is needed. Trial registration Pan African Clinical Trial Registry, https://pactr.samrc.ac.za/ (PACTR202302787440132). Registered on 06/02/2023.

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“…Blood transfusion is the process of transferring blood or its components, such as plasma, red blood cells, or platelets, from the donor to the recipient (1). It is a potentially lifesaving procedure by replacing blood loss due to surgery, injury, and certain medical conditions (2). The need for blood transfusion in this world is increasing, and it is required by approximately 1 out of 7 patients who are admitted to the hospital (3).…”

Section: Introductionmentioning

confidence: 99%

Blood Transfusion Practices at The Intensive Observation Unit (Ruang Observasi Intensif/ROI) of Dr. Soetomo General Academic Hospital Surabaya

Sabila

Maulydia²,

Tambunan³

et al. 2023

IJAR

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Introduction: Blood transfusion is the process of transferring blood or its components, such as red blood cells, plasma, and platelets, from donor to recipient. The major reason for blood transfusion is anemia and bleeding, frequently seen in critically ill trauma patients in Intensive Observation Unit (Ruang Observasi Intensif/ROI). One of the most prevalent causes of potentially preventable death in trauma patients is uncontrolled bleeding. In addition to controlling the bleeding by surgical or interventional procedures, blood transfusion is carried out to maintain oxygenation to tissue, preventing organ dysfunction due to hypoxia. Objective: This study aimed to determine the profile of blood transfusion carried out on the patients in the ROI of Dr. Soetomo General Academic Hospital. Materials and Methods: This retrospective descriptive study was conducted using medical records involving 258 patients who met the inclusion criteria. Results: The result showed that the majority of patients were female, aged 26-35 years, had blood type O, and Rhesus (Rh)-positive, accounting for 55.04%, 26.36%, 39.53%, and 100%, respectively. The most common indication for transfusion was anemia, with a percentage of 69.10%, particularly severe anemia, accounting for 48.45%. Furthermore, 57.36% of patients were from the surgery department, and 36.05% stayed in ROI for 2-3 days. The most common blood component and unit transfused was packed red blood cells (PRC), with a percentage of 57.50% and 439 units at 47.82%. Most of the transfusions, with a percentage of 37.80%, were carried out within 3-4 hours. Some patients were experiencing pruritus, febrile, urticaria, and chills, accounting for 0.39%, 0.39%, 0.39%, and 0.39%, respectively. Conclusion: Understanding transfusion practices, including blood type distribution, can prevent blood shortage, estimate the need for blood among ROI patients in Dr. Soetomo General Academic Hospital, and further ensure that all transfusions are ABO and Rh compatible.

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Mortality and its associated factors in transfused patients at a tertiary hospital in Uganda

Cited by 4 publications

References 38 publications

Comprehensive Evaluation of Blood Product Transfusions Administered in the Emergency Department

Comprehensive Evaluation of Blood Product Transfusions Administered in the Emergency Department

A randomized control trial to compare mortality in recipients of leucoreduced and non-leucoreduced whole blood transfusion in patients with cancer in Uganda

Blood Transfusion Practices at The Intensive Observation Unit (Ruang Observasi Intensif/ROI) of Dr. Soetomo General Academic Hospital Surabaya

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