Frequency and clinical characteristics of adverse transfusion reactions in hospitalized patients: A retrospective review of electronic medical records

Purpose: Adverse transfusion reactions (ATRs) are unfavorable reactions to the transfused unit, and the severity may be different among individuals, depending upon the type of reactions and the patient's susceptibility. It is necessary to operate and manage a systematic monitoring system to minimize these ATRs and increase the safety. This study was conducted to evaluate clinical features of transfusion-related adverse events and morbidities. Methods: We retrospectively analyzed transfusion data from electronic medical records during the recent 3 years (April 2017 to April 2020) at Seoul National University Bundang Hospital.The electronic search strategy was applied to search for the type of blood products prescribed and identify symptoms that occurred during transfusion as recorded in the nursing chart which is based on the International Classification for Nursing Practice. Results: A total of 18,772 people were transfused during the study period. A total of 524 people were reported as suspected ATRs, of whom 466 were finally confirmed. Red blood cell was the most frequent culprit blood product (59.9%), followed by apheresis platelet (25.1%), fresh frozen plasma (10.1%), and platelet (4.9%). Clinical symptoms included fever (54.9%), urticaria and itching (34.7%), chillness and shivering (21.9%), and chest discomfort (6.0%), dyspnea (5.3%), cold sweating (3.8%), hypotension (2.1%), and palpitations (1.9%).The severity of ATRs were mild (91.8%), moderate (7.1%), and severe (1.1%). Conclusion: ATRs are mostly mild, but life-threatening reactions may occur. Physicians should be aware of various features of ATRs to appropriately recognize and treat such patients.