Assessment of platelet transfusion outcome and Factors associated with platelet refractoriness among platelet transfused adult patients at Saint Paul HospitalMillennium 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 count
does not increase as expected following platelet transfusion and associated with both immune
and non-immune mechanisms. It is a significant clinical outcome in platelet transfusion.
Objective: To assess Platelet transfusion outcome and factors associated with platelet
refractoriness among platelet transfused adult patients at Saint Paul Hospital Millennium
Medical College Addis Ababa, Ethiopia.
Methods: Hospital based cross sectional study was carried out at Saint Paul Hospital
Millennium Medical College from November 01/2022 to June 30/2023. Convenience
sampling techniques and structured questionnaires used to collect patient demographic and
clinically relevant data. Blood sample was collected in Ethylediaminetetracid acid tube and
run on Beckman coulter heamatolgy analyzer. Platelet refractoriness was identified using
corrected count increment 1 hour, 18 to 24 hrs of transfusion and also descriptive statistics
was 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 factors
associated to platelet refractoriness were analyzed by Multivariate logistic regression. A P
value of less than 0.05 was considered as statistically significant.
Results: Of the total 216 patients, 28% had platelet refractoriness. we identified that platelet
refractory patients associated with 1hr post platelet refractoriness , had previous history of
transfusion(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 18-24hrs
were associated with ABO non identical platelet(AOR:95% Cl 1.49,119.91, p=0.022).On the
other hand platelet storage were lower significant with platelet refractory patients.
Conclusion: This study demonstrated that statistical different independent variables
associated with platelet transfusion refractoriness among platelet transfused adult patients.
Factors found to be correlated with platelet refractoriness were previous history of
transfusion, Chemotherapy, prolonged hospital stay for longer time, fever, splenomegaly and
ABO non identical platelet.
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Keywords
Refractoriness, Platelet transfusion, Platelet