Hospital Blood Research Articles

A 6-month Review of pRBC Transfusion Practices in a Tertiary Institution in Brooklyn, NY

Abstract Introduction/Objective Many factors are considered when managing hospital blood inventory. Because demographics and types of services vary per institution, a conscious effort to survey the prevalence of different blood types is necessary to make better predictions of inventory adequacy and decrease inappropriate use of O pRBC units. Methods/Case Report We reviewed the transfused pRBC units between October 2023 and March 2024 to determine the number of patients receiving ABO-type specific units and the number of D+ patients receiving D- units. Results (if a Case Study enter NA) After review, the patient population was found to be approximately 80% African Americans. Most of our patients were D+ with a monthly average of 224 patients. In contrast, we served 15 D- patients per month (PPM). Between 21-33% of D+ patients received D- units. O blood type was the most common, with an average of 224 PPM, followed by A blood type at 57 PPM and B blood type at 51 PPM. Since we see an average of 10 AB blood type patients monthly, it wasn’t surprising that they all received non-type specific units. Noteworthy is the significant proportion of A and B blood type patients receiving ABO type-specific units, ranging from 74-85% for A blood type and 70-90% for B blood type. Conclusion Our institution’s commitment to hemovigilance and conservation of O units is evident in the relatively high percentage of patients receiving ABO-type specific units. It is worth noting that we are a tertiary institution mainly serving the African American population. This creates a unique need to maintain adequate O units for emergency transfusion and increase the possibility of using O units to meet our sickle cell disease patients’ needs. Given that our demographics are primarily D+, some of our D- units were utilized in D+ patients. By adhering to our transfusion protocol and surveying our patients’ ABO and D blood types, we can anticipate our inventory needs and help prevent future O pRBC shortages.

Low-Titer O-Positive Whole Blood: Lessons From the Battlefield for Civilian Rural Hospitals.

Low-titer O-positive whole blood was used extensively by the military during operations in Iraq and Afghanistan. Studies have consistently shown that this therapy is feasible, safe, and effective in the management of hemorrhagic shock in trauma patients, and it is now the standard of care across the US military Joint Trauma System. The military's success in using low-titer O-positive whole blood has renewed the practice in the civilian setting, with recent research confirming its safety and efficacy. In a few short years, use of this treatment for hemorrhagic shock has expanded to more than 80 US level I and level II trauma centers. However, its use is still relatively rare in the rural hospital setting. This article describes the benefits for patients, staff members, and the overall trauma system of using low-titer O-positive whole blood in rural hospitals.

A study to reveal the rationales of overnight transfusion in a training and research hospital

BackgroundMonitoring of overnight transfusions would be beneficial to improve blood transfusion safety. The objective of this study was to prospectively evaluate the practice and need for overnight transfusions (OT) in a teaching and research hospital. MethodsThe study was conducted on data from patients who received packed red blood cells (PRBCs) transfusions between 11 September and 13 October 2023 at a Training and Research Hospital in Ankara, Turkey. Clinical data of patients were obtained from the Hospital Database Management System (HDBS) and blood transfusion order forms. The critical time point of the transfusion process was recorded using HDBS. ResultsA total of 1502 PRBCs transfusions were noted during the study period, of which 400 (26.6%) were OT. OT was most frequently administered to patients with symptomatic anemia (34.6%; 138/400) and patients with an Hb level <7 (27.7%; 111/400). The time interval in which OT was most frequently ordered was between 15:00 and 17:00 [20.2% (81/400)], while the most frequent time to start transfusion was between 17:00 and 19:00 [22% (88/400)]. The average time taken from ordering OT to starting OT was 3 hours 41 minutes. The most of patients (36.8%; 91/248) were discharged after 48 hours of transfusion or were still in the hospital for more than 48 hours (20.3%; 50/248). ConclusionTo ensure transfusion safety by reducing OT to a minimum, OT should be used only in emergencies, policies should be put in place to make sure that transfusions can be done during the day easily, and healthcare professionals should be made aware of this issue.

Knowledge and Attitudes of Blood Donors Toward Sickle Cell Anemia in Ibadan.

Background Sickle cell anemia (SCA) is a common condition of public health concern in Nigeria. Different therapeutic approaches have been developed to manage SCA, including blood transfusion. In a bid to develop a sustainable solution to the blood supply pool, the SmileBuilders Initiative organizes a blood donation drive (Donate-A-Pint Project) quarterly in Ibadan, Nigeria. This study aimed to assess the awareness, knowledge, and attitudes of blood donors in Ibadan, Nigeria, towards SCA. Methods A descriptive cross-sectional study was conducted at the University College Hospital Blood Bank in Ibadan over a period of three months. A validated questionnaire, based on similar studies in Nigeria, was used to collect data from blood donors. The SPSS version 23 was used for data analysis, and the chi-square test of independence assessed associations between variables, with a significance level of 0.05. Results Among 205 donors, 68.8% were male, and 42.4% were in the age category of ≥25 years. Most donors (60.0%) were university students. While 12.3% had never heard of SCA, 79.5% were aware of their genotype. Regarding the intrauterine diagnosis of hemoglobin SS (HbSS), 20.0% would allow pregnancy, 31.7% would abort, and 48.3% were undecided. Most respondents (73.2%) had good knowledge of SCA (mean score = 7.0/10.0). If partners were found to have SCA after marriage, 42.9% were undecided. Knowledge of SCA was significantly associated with sex (p = 0.017) and education level (p = 0.001). Conclusion Blood donors in Ibadan have good knowledge, awareness, and attitudes toward SCA. However, more health education would benefit the population.

Risk factor stratification for urgent and nonurgent transfusion in patients giving birth

BackgroundA common approach to attempt to reduce maternal morbidity from hemorrhage is to recognize patients at increased risk, and to make advance preparations for possible blood transfusion in these patients. Preparation may consist of a hold clot, type, and screen, or crossmatch. Most hospitals, including ours, have pathways or guidelines that lay out which of these preparations should be made at the time a patient is admitted to labor and delivery. These are often based on risk factors for hemorrhage but do not take into account the probability that transfusion will be needed. The cost-effectiveness of performing a type and screen or routine crossmatch on patients admitted for delivery has been questioned. Several studies have shown that the chance of transfusions in individuals giving birth is very low. In terms of the need for routine blood preparation, the need for urgent transfusion is most relevant. This has not been included in studies of transfusion rates. ObjectiveThe purpose of this study was to quantify the relative importance of risk factors present on admission for needing a blood transfusion and to develop a formula to define each individual's risk. This could then be used to decide an appropriate level of initial blood preparation for patients at different risk levels. Study DesignRisk factors for hemorrhage and the level of transfusion preparation were extracted from the medical records of a cohort of 89,881 patients delivering in an 18-hospital healthcare system over 40 months. We tabulated the number who required at least one RBC transfusion and the number needing an urgent transfusion-defined as receiving blood during labor or within 4 hours after delivery. Odds ratios for requiring a transfusion were calculated for each risk factor. We then calculated the probability of needing a transfusion for each patient based on their risk factor profile. ResultsA total of 643 patients had any transfusion during their hospitalization (0.72% of deliveries), and 311 had an urgent transfusion (0.35% of deliveries). The calculated probability of needing a transfusion was less than 1% in 87.8% of patients and was greater than 5% in 1.2% of patients. The chance of needing a transfusion was highest for placenta accreta spectrum, admission Hgb <8.0, and placenta previa. A second tier of risk factors included abruption, bleeding with no specific diagnosis, and Hgb between 8.0 and 10.0. ConclusionIn our cohort, very few patients received a transfusion. Applying a formula derived from patient-specific risk factors, we found that almost all patients have a very low probability of needing a transfusion, especially an urgent transfusion. Based on these results, we suggest that a hold clot be used except for the highest-risk patients or in settings with barriers to procuring blood in the rare case of urgent transfusion need. Making this change would greatly reduce hospital blood bank charges.

Improving Blood Transfusion Request Form Documentation: A Quality Improvement Project.

The transfusion quality improvement project (QIP) serves as a valuable toolfor assessing and educating individuals who request blood components.The World Health Organization (WHO) recommends that each institution utilize a blood transfusion request form to ensure the effective conveyance of patient information to the hospital's blood bank. This QIPaimed to implement a transfusion request form and measure compliance with its use. A prospective study was conducted at Al Managil Teaching Hospital, Sudan, from May 1 to August 3, 2024, to address the lack of standardized transfusion request forms. The study included three cycles involving pre-intervention analysis, two phases of intervention with training sessions, and post-intervention evaluations. The interventions focused on developing and implementing a new transfusion request form, training clinical physicians, and reinforcing the form's use. Data from 100 randomly selected transfusion request forms were analyzed for completeness and adherence. The study showed significant improvements in the completeness of transfusion request forms across three cycles. In the first cycle, no data were collected, highlighting the absence of standardized forms. During the second cycle, with the introduction of the new form, the completion rates varied: some fields, such as patient information and clinical details, were fully completed in 50 cases (100%), while critical clinical parameters, such as current hemoglobin (Hb) and platelet (PLT) levels, were completed in only four requests (8%). By the third cycle, there was a substantial increase in completion rates across all domains. For example, patient information fields achieved 100% completion in 50 cases, and clinical parameters saw significant improvement, with current Hb and PLT levels documented in 48 cases (96%). The mean percentage completion increased from 68.1% in the second cycle to 97.9% in the third cycle, demonstrating the effectiveness of the interventions and training sessions. Minor decreases were observed in health insurance documentation and certain clinical details, indicating areas for further improvement. The systematic implementation and iterative evaluation of transfusion request forms significantly enhanced documentation completeness.

Seroprevalence of transfusion transmissible infections (TTIS) among blood donors in SOS hospital Heliwa, Somalia

BackgroundA transfusion-transmissible infection (TTI) refers to any infection that can be spread from one person to another through the injection of blood or blood products. The prevalence of these infections varies across countries, influenced by the disease burden within each population. To assess the severity of TTIs, the World Health Organization (WHO) has mandated pre-transfusion blood tests for Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and syphilis. This study aimed to determine the seroprevalence and trends of TTIs among blood donors at SOS Hospital in Mogadishu, Somalia, from 2016 to 2022. MethodsA retrospective cross-sectional analysis was performed by examining SOS Hospital's blood bank records spanning from 2016 to 2022. The research included all blood donors screened for transfusion-transmissible infections (TTIs) during this period. Data obtained was input and analyzed utilizing Statistical Package for Social Science (SPSS) v.25.0 and Microsoft Excel 2010. Frequencies and percentages were calculated as part of the descriptive statistics. To analyze trends, Chi-square analysis was applied, and statistical significance between variables was determined using the p-value. ResultsThere was a total of 36,296 people donated blood during study period. The majority of blood donors were males (99.8 %), primarily aged between 25 and 44 years (80.4 %) with family donors constituting 80.8 % of the participants. Among 36,296 donors, 1087 (2.99 %) tested positive for transfusion-transmissible infections (TTIs), declining from 4.27 % in 2016 to 1.98 % in 2022. The Chi-Square test confirmed a highly significant reduction in TTIs from 2016 to 2022 (X2 = 57.625, p < 0.0001), indicating a decreasing trend over the seven-year period. Conclusion and recommendationsThis study uncovers a moderate prevalence of transfusion-transmitted infections, indicating a notable decrease over time. Additionally, the findings underscore a gender disparity in blood donation, with replacement donors being predominant. It is imperative to conduct multi-center research endeavors to precisely identify the factors influencing transfusion-transmitted infections among blood donors.

Trend in the Seroprevalence of Transfusion Transmissible Infections (TTIs) from 2019 to 2023 at the Blood Transfusion Service of the Buea Regional Hospital, Southwest Region, Cameroon

Background: Transfusion-transmissible infections (TTIs) are of significant public health concern, as they can be transmitted through blood transfusions. Monitoring the trends and prevalence of TTIs is crucial for ensuring the safety of the blood supply and implementing effective preventive measures. This study aimed to analyzed the trend in seroprevalence of TTIs, including HIV, hepatitis B (HBV), hepatitis C (HCV), and syphilis (TPHA), among blood donors in the Buea Regional Hospital (BRH) from 2019 to 2023. Materials and Methods: This retrospective study was conducted using data from the Buea Regional Hospital Blood Transfusion Service. The study population included all blood donors who donated blood from January 2019 to December 2023. Serological testing for TTIs was performed using standard diagnostic methods. The prevalence of each TTI was calculated for each year, and the trends were analyzed using statistical tests and expressed as frequency tables, Chi square, logistic regression. Significance was set at p=0.05. Results: A total of 11,256 donors were tested and 919 (8.12%) blood donors tested positive for at least one TTI agent during the study period. The overall positivity rates were 8.23%, 9.48%, 6.65%, 8.29%, and 8.24% for 2019, 2020, 2021, 2022, and 2023, respectively. The prevalence of individual TTIs showed significant variations, with TPHA being the most prevalent (2.96%), followed by HBV (2.58%), HCV (1.15%), and HIV (1.24%). Socio-demographic factors, such as gender, marital status, occupation, and age, were found to be significantly associated (p&lt;0.001) with the odds of testing positive for a TTI. Conclusion: The trend in the prevalence of TTIs among blood donors in the Buea Health Area was characterized by fluctuations over the five-year period.

Prevalence and patterns of echocardiographic abnormalities among people living with HIV on anti-retroviral therapy in Kumasi, Ghana

BackgroundEchocardiography can be used to screen, confirm, and assist in the management of some cardiovascular diseases in people living with human immunodeficiency virus (HIV) (PLWH). Thus, complications from subclinical cardiovascular conditions or more apparent conditions, such as massive pericardial effusion with tamponade, can be promptly identified and managed to minimize cardiovascular morbidity and mortality associated with HIV infection. Since the introduction of antiretroviral therapy (ART) in Ghana approximately two decades ago, studies on the prevalence and patterns of echocardiographic abnormalities among PLWH on ART have been limited. This study was designed to assess the prevalence and patterns of echocardiographic abnormalities among PLWH on ART.MethodsThis was a cross-sectional study. PLWH on ART (cases) attending the HIV clinic at Komfo Anokye Teaching Hospital (KATH) and HIV-negative blood donors (controls) were consecutively recruited and enrolled in this study. The interviews were performed via a standardized questionnaire. After a clinical examination was performed, all patients underwent two-dimensional (2D) and Doppler transthoracic echocardiograms. The prevalence and patterns of echocardiographic abnormalities were characterized.ResultsThere were 117 patients in each arm of the study. There were more females than males among both the cases (92 (78.6%) and controls (80 (68.4%)); however, the sex distribution was similar between the two groups (p = 0.075). For clinical characteristics such as age, weight, height and blood pressure, there were no statistically significant differences between the cases and controls. Echocardiographic abnormalities were more frequently observed and demonstrated a statistically significant difference between cases and controls, with an overall prevalence of 35.0% among cases and 19.7% among controls (p = 0.008). The echocardiographic abnormalities that demonstrated significant differences between the cases and controls were left ventricular (LV) diastolic dysfunction (28.2% versus 8.6%; p = 0.000) and LV hypertrophy (7% versus 0.9%; p = 0.017).ConclusionNearly 1 in 3 PLWH on ART had an echocardiographic abnormality in this Ghanaian study. Echocardiograms are recommended as helpful screening modalities for diagnosing cardiac abnormalities among PLWH on ART.

Management Strategies for Hypertensive Crisis: A Systematic Review.

A hypertensive crisis is defined as a sudden and significant rise in blood pressure. The blood pressure reading is 180/120 mmHg or higher. A hypertensive crisis is a medical emergency. It can lead to a heart attack, stroke, or other life-threatening medical problems. Investigating the management of the hypertensive crisis was the goal of this study. English-language articles were collected from 2010 to 2024 demonstrating the management of the hypertensive crisis. Overall, there were 15 articles. Surveys and analyses of national databases were the most widely used methods (n=15). The scientific studies documented (1) all investigative studies or reports that included a hypertensive crisis diagnosis, (2) data integrity and reproducibility, and (3) management studies.Other studies show that acute severe hypertension in the hospital is associated with high rates of mortality and morbidity, particularly with new or worsening end-organ damage. The problem is linked to poor medical adherence, but alarmingly low follow-up rates are likely to contribute to a high recurrence rate. The treatment of acute severe hypertension varies according to the hospital unit (medical ward or intensive care unit), medication, and blood pressure targets or thresholds. Because of a lack of evidence-based guidance, arbitrary blood pressure control targets are used, or blood pressure targets are crudely extrapolated from guidelines intended primarily for outpatient management. Patients with acute aortic dissection need to be administered intravenous esmolol within 5 to 10 minutes in order to lower their blood pressure right away. The goal is to maintain a systolic reading of less than 120 mm Hg. Vasodilators such as nitroglycerin or nitroprusside may be administered if the blood pressure persists following beta blocking. Intravenous administration of clevidipine, nicardipine, or phentolamine is required; the initial dose is 5 mg, with subsequent doses given every 10 minutes as necessary to achieve the desired reduction in blood pressure.

The Relationship of PCLR Therapy on Hemoglobin Levels in Anemia Patients at BDRS MMC Jakarta (January-April 2022)

Anemia is generally characterized by a decrease in hemoglobin levels. In terms of function, a decrease in hemoglobin causes a reduction in the body's need for oxygen in sufficient quantities. PCLR (Packed Red Cell Leukoreduced) is a concentrated red blood cell product obtained through the process of reducing leukocytes, so PCLR transfusion is expected to increase Hb levels in anemia patients. This study aims to determine the relationship between PCLR administration and hemoglobin levels in anemia patients and to determine the increase in hemoglobin levels after PCLR transfusion at MMC Hospital Blood Bank (BDRS MMC) Jakarta. Quantitative (analytical) research methods. The sample in this study was 140 data from anemia patients who underwent PCLR transfusion (January-April 2022). Data analysis was carried out univariate and bivariate. The research was carried out at MMC Jakarta Hospital in July 2022. Research results: the majority of patients were elderly (56-&lt;65 years) 67 people (47.9%), the majority gender was female 82 people (58.6%); there was an increase in Hb levels after PCLR transfusion, namely 1.89 gr/dL with an average use of 2 bags; and there is a relationship between PCLR administration and hemoglobin levels in anemia patients at BDRS MMC Jakarta. Suggestion: to achieve an increase in hemoglobin in anemia patients, PCLR can be used as a blood component of choice for transfusion at the right dose.

The Relationship between the Level of Satisfaction of Blood Delivery Workers with Five Dimensions of Service Quality at UDD PMI Bekasi Regency in 2023

(1) Hospital Blood Bank (BDRS) is one of the health service facilities to meet the needs of blood transfusions of patients but does not rule out the possibility that blood stocks in BDRS are not available so they require assistance from the Indonesian Red Cross Blood Donor Unit (UDD PMI) in meeting the blood needs of patients. UDD PMI Bekasi Regency is carried out almost every time, regardless of the time and weather at that time. Blood collection is usually done by special officers from the hospital. This officer is what connects the chain of blood requests BDRS to UDD PMI Bekasi Regency, where later the officer will carry out blood retention and memory. (2) This research aims to determine the level of ability to use five dimensions quality services to have reliability, response, empathy, and blood transmission in UDD PMI District Bekasii. (3) Methodology This study by distributing questionnaires to 52 blood delivery officer respondents, data processing using data analysis of satisfaction index and ordinal logistic regression, namely simultaneous tests, partial tests, and model conformity tests (Hosmer-Lemeshow Goodness-of-fit Test). (4) The results of this study show that the level of satisfaction of blood delivery officers is based on five dimensions of satisfaction with UDD PMI district services. Bekasi has very satisfactory criteria.

An Overview Of Temperature And Quality Of Packed Red Cell (PRC) Components Based On Distance And Delivery Time

The Indonesian Red Cross is responsible for the distribution of blood products to hospital blood banks. The daily blood distribution route will vary due to the fact that the number of blood requests and the number of hospital blood banks vary on a daily basis. The implementation of a cold chain system is one method of optimizing blood distribution and transportation activities. The objective of this investigation is to evaluate the temperature and quality of PRC components in relation to their delivery time and distance. This research method is quantitative-descriptive. The population of this study consisted of all blood that was donated to the hospital blood bank in Sidoarjo Regency between October and November 2022. The blood sample used in this study was collected from the UDD PMI Sidoarjo Regency. The sampling technique of accidental sampling would be employed to visually identify the quality of PRC and temperature. The results of this study indicated that 460 PRC bags were delivered to three hospital blood banks in the UDD PMI Sidoarjo Regency. The PRC did not experience lysis, and 50 bags (10.86%) of the 460 PRC bags experienced a temperature change of over 10 °C. Conclusion: The temperature of the dropped PRC components is influenced by the delivery time and distance. The SOP must be strictly adhered to by all officers who distribute and transport blood to guarantee that the quality of the blood remains in good condition.

Assessing the implications of using RDTS in donor blood screening for transfusion-transmissible infections (TTIs): analysis of trans-in donor blood at a Tertiary Hospital in Ghana

BackgroundBlood transfusion is a critical hemotherapeutic intervention. However, the widespread utilization of Rapid Diagnostic Test (RDT) methods in screening potential donors for TTIs poses a serious public health challenge. We investigated the prevalence of TTIs in donor blood units that were transported from external health facilities (Trans-in blood) to Ho Teaching Hospital for critical care. MethodWe adopted a cross-sectional design to investigate 727 units of Trans-in blood at the Ho Teaching Hospital's blood bank between January 1, 2021, to December 31, 2022. An apriori-developed data capture form was used to collect the data for this study. The chi-square test and Cramer's V or Phi were used to assess the association between variables of interest. Binary logistic regression analysis was used to determine the association between TTIs and donor's blood groups whereas spatial visualization was employed to present the distribution of missed TTIs. ResultsThe overall prevalence of missed TTIs was 6.19 % (95 % CI: 4.66–8.18), comprising missed HIV, HBV, and Syphilis infection rates of 1.79 % (95 % CI: 1.72–1.86), 1.24 % (95 % CI: 1.17–1.31), and 3.16 % (95 % CI: 3.09–3.23), respectively. There was a higher rate of missed HIV infections in 2022 (2.04 %, 95 % CI: 1.04–3.97) compared to 2021 (1.49 %, 95 % CI: 0.64–3.45), and a decline in the rates of missed HBV and Syphilis infection within the period. The prevalence of TTI was highest among donors with ABO blood group 'O' (68.89 %, 95 % CI: 54.34–80.47) and Rh 'D' Positive blood group (95.56 %, 95 % CI: 85.17–98.77). Compared to donors with blood group O, non-O donors had 4.53 times the odds (95 % CI: 1.12–18.27; p-value=0.034) of missed HBV infection. ConclusionThe observed prevalence of missed TTIs highlights potential gaps in current screening practices, posing a significant public health concern. Efforts made to clamp down on the spread of these infections within the population may be impeded if the current trend of missed TTIs continues. Further studies on a larger scale with more comprehensive data are advised to better appreciate the public health implications of missed TTIs in Ghana.

Prevalence of C282Y, H63D and S65C gene mutations in patients with hyperferritinemia undergoing therapeutic phlebotomy suspected of having hereditary hemochromatosis

Background: Hemochromatosis is an autosomal recessive disorder caused by excessive iron overload in parenchymal organs. In Brazil, the prevalence of hereditary hemochromatosis (HH) may vary compared to other countries due to different ethnical backgrounds according to the geographic region studied. The prevalence of C282Y mutation of the HFE gene ranges from three to eight times lower in Brazilians than in Caucasians of Northern European origin. Methods: A retrospective cross-sectional study was carried out in 222 patients submitted to therapeutic phlebotomy between March 2011 and July 2014 in a tertiary hospital blood center. The prevalence of HH was determined in 89 (47.3%) out of 188 (84.6%) patients presenting hyperferritinemia, and divided in two genotype groups: C282Y mutation and other mutations. The HH patients’ geographical and clinical characteristics, serum ferritin rate (SF) and transferrin saturation (TS) were analyzed. Results: The HH group consisted of 71 males (79.7%) and 18 (20.3%) females, with a median age of 51.5 ± 10.6 years. There were 36 (40.0%) symptomatic patients and 65 (73.0%) tested positive for the HFE mutation. The initial baseline TS values were significantly higher in primary HH patients (48.6%, IC 95% 43.2% - 55.7%) compared to those with secondary HH (35.0%, IC 95% 27.5% 41.8%, p=0.001). Conclusion: The prevalence of C282Y mutation was higher in this population from the South region compared to previous reports in the Brazilian population, yet inferior to that of Northern Europeans.

Blood Donor Characteristics at a Hospital Blood Bank in Saudi Arabia: A Trend-analysis

Abstract BACKGROUND: Identification of blood donor profiles helps with recruitment and retention strategies. OBJECTIVES: To describe donor characteristics at a hospital blood bank and to describe any changes in donor characteristics throughout the study period. METHODS: In this retrospective observational study, we reviewed the blood bank records from 2005 to 2022. Characteristics of donors (age 18 or above) were collected. Percentages of donors according to various characteristics were described in 3-year intervals and compared using the Chi-square test. RESULTS: Over the study period, 226,576 blood donations were identified. Most donors were men, and half were non-Saudi nationals. Approximately two-thirds of the blood donors (145,794, 64.3%) were between 25 and 44 years old, and (59,650, 26.3%) were between 18 and 24 years old. When donors were compared across time intervals according to the age group, the percentage of donors 18–24 years old decreased over time from 31.4% in the interval 2005–2007 to 23.5% in the 2020–2022 interval. Significant changes were seen in the percentages of repeat donors as well. CONCLUSIONS: Donation trends showed significant changes related to donor age, gender, and nationality as well as donor type (new or repeat donor), the most notable being that donations by younger adults have decreased. Marketing plans must be implemented to target and retain this donor population. Further research is required for the detailed characterization of donors across the country to ensure the sustainability of the blood supply.

Novel approach exploring the correlation between presepsin and routine laboratory parameters using explainable artificial intelligence

Although presepsin, a crucial biomarker for the diagnosis and management of sepsis, has gained prominence in contemporary medical research, its relationship with routine laboratory parameters, including demographic data and hospital blood test data, remains underexplored. This study integrates machine learning with explainable artificial intelligence (XAI) to provide insights into the relationship between presepsin and these parameters. Advanced machine learning classifiers provide a multilateral view of data and play an important role in highlighting the interrelationships between presepsin and other parameters. XAI enhances analysis by ensuring transparency in the model's decisions, especially in selecting key parameters that significantly enhance classification accuracy. Utilizing XAI, this study successfully identified critical parameters that increased the predictive accuracy for sepsis patients, achieving a remarkable ROC AUC of 0.97 and an accuracy of 0.94. This breakthrough is possibly attributed to the comprehensive utilization of XAI in refining parameter selection, thus leading to these significant predictive metrics. The presence of missing data in datasets is another concern; this study addresses it by employing Extreme Gradient Boosting (XGBoost) to manage missing data, effectively mitigating potential biases while preserving both the accuracy and relevance of the results. The perspective of examining data from higher dimensions using machine learning transcends traditional observation and analysis. The findings of this study hold the potential to enhance patient diagnoses and treatment, underscoring the value of merging traditional research methods with advanced analytical tools.

Evolución de la seroprevalencia de COVID-19 en bancos de sangre durante la pandemia en la región Lima, Perú

Introduction. Peru was one of the countries most affected by the COVID-19 pandemic, with more than 220,000 deaths recorded due to SARS-CoV-2 infection. Given the constant mutations of the virus and registered variants, it is important to carry out research that reflects the evolution of the humoral immune state. Objective. Measure the seroprevalence of COVID-19 during the pandemic in the department of Lima in the period between April 1, 2020 and June 30, 2022, in donor samples from 6 hospital blood banks public of Lima, Peru. Methods. A descriptive, transversal, observational and retrospective study was carried out evaluating the presence of IgM/IgG antibodies against SARS-CoV-2 using lateral flow chromatographic immunoassay in samples from healthy and asymptomatic donors from blood banks of 6 health facilities in the department of Lima. Results. A progressive increase in the seroprevalence of IgG and total reactivity of IgM/ IgG antibodies against SARS-CoV-2 will be observed as follows: 22,6% - 32,7% during 2020; 53,9% - 58,1% during 2021; 88,9% - 93,3% during the first half of 2022. Conclusions. The reactivity and presence of anti- SARS-CoV-2 antibodies progressively increase during the COVID-19 pandemic from 11,2% to 98,4% in the samples evaluated, possibly with the impact of the pandemic waves and the active vaccination campaign against COVID-19.

Sociodemographic features, serum urea, creatinine and blood urea nitrogen/creatinine ratio in chronic kidney disease patients – A record based retrospective study

Objectives: Chronic kidney disease (CKD) is a progressive reduction in renal function. It is a condition where the kidneys lose their normal function, especially excretory and regulatory functions. Urea and creatinine are good indicators of a normal functioning kidney and an increase in the serum indicates kidney dysfunction. Blood urea nitrogen (BUN) and serum creatinine are widely accepted and the most common parameters to assess renal functions. The present study was done to assess the serum urea, creatinine levels, and BUN-creatinine ratio (BCR) in CKD subjects. Material and Methods: It was a record-based retrospective study. Data were obtained from the Medical Records Department. The patients diagnosed with CKD in August 2023 were extracted from the records. Details such as hospital ID, age, gender, and blood parameters such as serum urea, creatinine levels, and BCR were obtained. Categorical data were summarized as frequency (percentage). Results: It was found that the number of male patients was 24 (75.4%) and the number of female patients was 14 (24.6%). The majority of patients belonging to the age group category of 50–75 were 42 in number (73.6%). Abnormal creatinine values were found in 54 patients (94.7%). Conclusion: The present study found that male gender and age group 50–75 years were most commonly affected with CKD. The serum creatinine level was found to be predominately abnormal compared to the serum urea level and BCR.

Comparison of No-Test Telehealth and In-Person Medication Abortion

In the US, access to medication abortion using history-based (no-test) eligibility assessment, including through telehealth and mailing of mifepristone, has grown rapidly. Additional evidence on the effectiveness and safety of these models is needed. To evaluate whether medication abortion with no-test eligibility assessment and mailing of medications is as effective as in-person care with ultrasonography and safe overall. Prospective, observational study with noninferiority analysis. Sites included 4 abortion-providing organizations in Colorado, Illinois, Maryland, Minnesota, Virginia, and Washington from May 2021 to March 2023. Eligible patients were seeking medication abortion up to and including 70 days' gestation, spoke English or Spanish, and were aged 15 years or older. Study groups reflected the model of care selected by the patient and clinicians and included: (1) no-test (telehealth) eligibility assessment and mailing of medications (no-test + mail) (n = 228); (2) no-test eligibility assessment and pickup of medications (no-test + pickup) (n = 119); or (3) in-person with ultrasonography (n = 238). Effectiveness, defined as a complete abortion without the need for repeating the mifepristone and misoprostol regimen or a follow-up procedure, and safety, defined as an abortion-related serious adverse event, including overnight hospital admission, surgery, or blood transfusion. Outcomes were derived from patient surveys and medical records. Primary analysis focused on the comparison of the no-test + mail group with the in-person with ultrasonography group. The mean age of the participants (N = 585) was 27.3 years; most identified as non-Hispanic White (48.6%) or non-Hispanic Black (28.1%). Median (IQR) gestational duration was 45 days (39-53) and comparable between study groups (P = .30). Outcome data were available for 91.8% of participants. Overall effectiveness was 94.4% (95% CI, 90.7%-99.2%) in the no-test + mail group and 93.3% (95% CI, 88.3%-98.2%) in the in-person with ultrasonography group in adjusted models (adjusted risk difference, 1.2 [95% CI, -4.1 to 6.4]), meeting the prespecified 5% noninferiority margin. Serious adverse events included overnight hospitalization (n = 4), blood transfusion (n = 2), and emergency surgery (n = 1) and were reported by 1.1% (95% CI, 0.4%-2.4%) of participants, with 3 in the no-test + mail group, 3 in the in-person with ultrasonography group, and none in the no-test + pickup group. This prospective, observational study found that medication abortion obtained following no-test telehealth screening and mailing of medications was associated with similar rates of complete abortion compared with in-person care with ultrasonography and met prespecified criteria for noninferiority, with a low prevalence of adverse events.