Assessment of Platelet Transfusion outcome and Factors Associated with Platelet Refractoriness among Platelet Transfused Adult Patients at Saint Paul Hospital Millennium Medical Collage Addis Ababa, Ethiopia.
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Date
2023-07
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Addis Ababa University
Abstract
Background: Platelet refractoriness is a clinical condition in which a patient's platelets countdoes not increase as expected following platelet transfusion and associated with both immuneand non-immune mechanisms. It is a significant clinical outcome in platelet transfusion.
Objective: To assess Platelet transfusion outcome and factors associated with plateletrefractoriness among platelet transfused adult patients at Saint Paul Hospital MillenniumMedical College Addis Ababa, Ethiopia.
Methods: Hospital based cross sectional study was carried out at Saint Paul HospitalMillennium Medical College from November 01/2022 to June 30/2023. Conveniencesampling techniques and structured questionnaires used to collect patient demographic and clinically relevant data. Blood sample was collected in Ethylediaminetetracid acid tube andrun on Beckman coulter heamatolgy analyzer. Platelet refractoriness was identified usingcorrected count increment 1 hour, 18 to 24 hrs of transfusion and also descriptive statisticswas used to present patient characteristics and clinical data. Paired t-test was used to compare platelet count, after and before platelet transfused to the patient and also factorsassociated to platelet refractoriness were analyzed by Multivariate logistic regression. A Pvalue of less than 0.05 was considered as statistically significant.
Results: Of the total 216 patients, 28% had platelet refractoriness. we identified that plateletrefractory patients associated with 1hr post platelet refractoriness , had previous history oftransfusion(AOR:95%Cl,3.61,38, p=0.001), were carried on chemotherapy(p=0.001)prolonged hospital stay (one month and above) p=0.025, fever (P=0.001),Splenomegaly(AOR:95% Cl,17.92 (5.44,59.03), p=0.025) and similarly, post platelet increment 18-24hrswere associated with ABO non identical platelet(AOR:95% Cl 1.49,119.91, p=0.022).On theother hand platelet storage were lower significant with platelet refractory patients.
Conclusion: This study demonstrated that statistical different independent variablesassociated with platelet transfusion refractoriness among platelet transfused adult patients.Factors found to be correlated with platelet refractoriness were previous history oftransfusion, Chemotherapy, prolonged hospital stay for longer time, fever, splenomegaly andABO non identical platelet.
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Keywords
Refractoriness Platelet transfusion Platelet