Assessment of transfusion utilization and patient outcomes at the largest referral and university hospital in Addis Ababa, Ethiopia

Abstract

BackgroundAssessment of blood and blood component utilization is an important tool to reduce inappropriate transfusions and to identify the frequency of blood and blood component utilization. However, in Ethiopia, the regular audit and assessment of transfusion practice is not routinely performed.ObjectiveTo characterize blood transfusion practices and monitor blood expiry and patient improvement status as an outcome at Black Lion Specialized Hospital (BLSH), Addis Ababa, Ethiopia.MethodsA 1‐year hospital‐based audit was conducted to analyse utilization of blood components and patient outcomes at the Black Lion Specialized Hospital blood transfusion service. The study was conducted between October 2010 and January 2011 on data of patients transfused from September 2009 to August 2010. Information on blood and blood component utilization was collected from the blood bank log book on 373 subjects. Data were analysed for descriptive statistics and univariate and multivariate analyses using SPSS version 15.0 (SPSS INC., Chicago, IL, USA).ResultsOf 361 transfused study subjects, 856 units of blood were transfused with the mean of 2·37 units per recipient. Whole blood was most commonly transfused to 307 (85%) patients, and the combination of two blood products was administered to 27 (7·5%) patients. Plasma was transfused only for a single patient (0·3%). For patients who did not clinically improve, 45 (66·2%) were those transfused with whole blood. Significant associations were found between the overall improvement status of patients with the health professional who ordered the transfusion and the type of blood and blood product administered.ConclusionTransfusion of blood components was very low, and there was a high rate of whole blood transfusions. When component therapy was used, the rate of patient improvement status after transfusion was high. Therefore, blood transfusion service programmes in Ethiopia should focus on component transfusion and the need to strengthen guidelines for the appropriate use of blood and blood components as clinical therapy.