Transfusion-related adverse reactions reported to the National Healthcare Safety Network Hemovigilance Module, United States, 2010 to 2012.
Transfusion-related adverse reactions reported to the National Healthcare Safety Network Hemovigilance Module, United States, 2010 to 2012.
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DOI：
10.1111/trf.12918
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发表时间：
2015-04
期刊：
影响因子：
2.9
通讯作者：
Kuehnert MJ
中科院分区：
文献类型：
--
作者：
Harvey AR;Basavaraju SV;Chung KW;Kuehnert MJ
2010年，美国的医疗机构开始自愿加入国家医疗安全网络（NHSN）血液警戒模块。参与者报告输血实践;红细胞，血小板（PLT），血浆和冷沉淀单位输注;和输血相关的不良反应和过程错误的疾病控制和预防中心通过一个安全的，互联网可访问的监测应用程序提供给使用设施。本分析包括提交2010年1月1日至2012年12月31日期间至少1个月的输血成分数据和不良反应的机构。按成分类型、收集和修改方法分层，计算输注成分的不良反应率。2010年至2012年，共有77家机构报告了2，144，723种输注成分中的5136例不良反应（239.5/100，000）。过敏（46.8%）和发热性非溶血性（36.1%）反应最常见;所有反应中7.2%为重度或危及生命，0.1%为致死性。血小板输注的不良反应发生率最高（421.7/10万）。美国NHSN血液警戒模块的不良输血反应率与其他国家的早期血液警戒报告相当。虽然严重反应并不常见，但美国医院的输血反应数量表明，预防这些反应的干预措施对患者安全很重要。需要进一步研究，以了解来自单采血液成分的反应的明显增加的风险。全面评价，包括数据验证，对于继续完善该模块至关重要。
In 2010, health care facilities in the United States began voluntary enrollment in the National Healthcare Safety Network (NHSN) Hemovigilance Module. Participants report transfusion practices; red blood cell, platelet (PLT), plasma, and cryoprecipitate units transfused; and transfusion-related adverse reactions and process errors to the Centers for Disease Control and Prevention through a secure, Internet-accessible surveillance application available to transfusing facilities. Facilities submitting at least 1 month of transfused components data and adverse reactions from January 1, 2010, to December 31, 2012, were included in this analysis. Adverse reaction rates for transfused components, stratified by component type and collection and modification methods, were calculated. In 2010 to 2012, a total of 77 facilities reported 5136 adverse reactions among 2,144,723 components transfused (239.5/100,000). Allergic (46.8%) and febrile nonhemolytic (36.1%) reactions were most frequent; 7.2% of all reactions were severe or life-threatening and 0.1% were fatal. PLT transfusions (421.7/100,000) had the highest adverse reaction rate. Adverse transfusion reaction rates from the NHSN Hemovigilance Module in the United States are comparable to early hemovigilance reporting from other countries. Although severe reactions are infrequent, the numbers of transfusion reactions in US hospitals suggest that interventions to prevent these reactions are important for patient safety. Further investigation is needed to understand the apparent increased risk of reactions from apheresis-derived blood components. Comprehensive evaluation, including data validation, is important to continued refinement of the module.
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