Epidemiologia das reações transfusionais em pacientes internados em um hospital de urgência de Goiânia / Epidemiology of transfusion reactions in patients interned in anemergency hospital in Goiânia

Hemovigilância pode ser definida como um conjunto de procedimentos de inspeção da cadeia transfusional. Esta obtém e processa informações de efeitos colaterais ou inesperados, resultantes do uso terapêutico de componentes lábeis do sangue e hemoderivados. O objetivo do estudo foi identificar e mapear a incidência de reações transfusionais que ocorram nos setores de um hospital de urgências de grande porte do estado de Goiás por meio das notificações realizadas no Notivisa, no período da sua inauguração em 2015 a julho de 2019. Trata-se de um estudo quantitativo, descritivo e transversal. A coleta de dados foi realizada através das fichas de notificação de incidentes transfusionais no Sistema de Informação Notivisa. Como resultado foi observado que o concentrado de hemácias é o componente sanguíneo que ocasionou mais reações transfusionais, onde a maioria das reações foi classificada como imediatas, em pacientes do sexo masculino com idade acima de 60 anos

Hemovigilance can be defined as a set of procedures for inspecting the transfusion chain. It obtains and processes information on side or unexpected effects resulting from the therapeutic use of labile blood components and blood products. The objective of the study was to identify and map the incidence of transfusion reactions that occur in the sectors of a large emergency hospital in the state of Goiás through the notifications made at Notivisa, during the period of its inauguration in 2015 to July 2019. A quantitative, descriptive and cross-sectional study. Data collection was performed using the transfusion incident notification forms in the Notivisa Information System. As a result, it was observed that the red blood cell concentrate is the blood component that caused the most transfusion reactions, where most reactions were classified as immediate, in male patients over the age of 60 years

Adverse Events and Risk Factors of Blood Transfusion in Cardiovascular Surgery: A Prospective Cohort Study

Abstract Background: Hemodilution, transoperative bleeding and cardiopulmonary bypass (CPB) are some of the factors associated with high transfusion rates in cardiac surgery. Objective: To analyze the incidence of blood transfusion and early postoperative outcomes in cardiac surgery patients. Methods: Cohort study of patients undergoing cardiac surgery in a university hospital, consecutively enrolled from May 2015 to February 2017. Data were prospectively collected and comparisons were made between two patients' groups: transfused and not transfused. Student's t-test, chi-square test, and logistic regression were used, and a p-value < 0.05 was considered significant. Results: Among the 271 patients evaluated, 100 (37%) required transfusion in the transoperative (32.1%) and/or postoperative periods (19.5%). The following predictors of transfusion were identified by multivariate analysis: EuroScore II (OR 1.2); chronic kidney disease (CKD) (OR 3.2); transoperative bleeding ≥ 500 mL (OR 6.7); baseline hemoglobin (Hb) ≤ 10 g/dL (OR 11.5); activated partial thromboplastin time (aPTT) (OR 1.1) and CPB duration (OR 1.03). Transfusion was associated with prolonged mechanical ventilation (≥ 24h) (2.4% vs. 23%), delirium (5.9% vs. 18%), bronchopneumonia (1.2% vs. 16%), acute renal failure (3.5% vs. 25%), acute on CKD (0.6% vs. 8%), stroke or transient ischemic attack (1.8% vs. 8%), intensive care unit stay ≥ 72 h (36% vs. 57%), longer hospital stay (8 ± 4 days vs. 16 ± 15 days), as well as increased early mortality (1.75% vs. 15%). Conclusion: EuroScore II, CKD, major transoperative bleeding, preoperative Hb and aPTT values and CPB time were independent predictors of transfusion, which was associated with a higher rate of adverse outcomes, including early mortality.

Risk factors for hepatitis B transmission in South Brazil

BACKGROUND Hepatitis B virus (HBV) infection is a major public health problem in Brazil. Several risk factors are involved in HBV infection and their identification by a rational and essential approach is required to prevent the transmission of this infection in Brazil. OBJECTIVES To evaluate risk factors associated with HBV infection in South Brazil. METHODS A total of 260 patients with HBV and 260 controls from Caxias do Sul (state of Rio Grande do Sul, Brazil) participated in this study. All participants were given a standard questionnaire to yield the sociodemographic information and to identify HBV risk factors. HBV infection was detected by HBsAg test in all participants. FINDINGS HBV infection in these cases was strongly associated with history of a family member HBV-infected, mainly mother [odds ratio (OR) = 4.86; 95% confidence intervals (CI): 1.69-13.91], father (OR = 5.28; 95% CI: 1.58-17.71), and/or siblings (OR = 22.16; 95% CI: 9.39-52.25); sharing personal objects (OR = 1.40; 95% CI: 1.37-2.38); and having history of blood transfusion (OR = 2.05; 95% CI: 1.10-2.84). CONCLUSIONS HBV infection was strongly associated with having a family member infected with hepatitis B, sharing personal objects, and having history of blood transfusion.

Factores de riesgo para la infección por el virus de la hepatitis C en la Costa Caribe colombiana: un estudio de casos y controles / Risk factors for hepatitis C virus infection in the Colombian Caribbean coast: A case-control study

Resumen Introducción. Se estima que, aproximadamente, 6,8 a 8,9 millones de personas están infectadas por el virus de la hepatitis C en Latinoamérica, de las cuales menos del 1 % llega a recibir tratamiento antiviral. En los estudios llevados a cabo hasta ahora en Colombia, se ha propuesto determinar la prevalencia de la enfermedad en algunos grupos de riesgo, y no se ha hecho el análisis de otros factores potencialmente implicados en el contagio. Objetivos. Determinar los factores de riesgo tradicionalmente analizados y otros no estudiados antes para la hepatitis C crónica en la Costa Caribe colombiana. Materiales y métodos. Se hizo un estudio de casos y controles (1:3) emparejados por empresa promotora de salud y edad (± 10 años), en el primer nivel de atención de hepatología y gastroenterología. A todos los pacientes positivos en la prueba ELISA se les hizo una prueba confirmatoria de carga viral. En el análisis de regresión logística multivariable se determinaron los factores predictores independientes de infección. Resultados. La transfusión sanguínea (odds ratio, OR=159,2; IC95% 35,4-715; p<0,001) y el antecedente de hospitalización antes de 1994 (OR=4,7; IC95% 1,3-17,1; p=0,018) se determinaron como los dos únicos factores independientes predictores de infección. Conclusión. Es necesario comprobar la reproducibilidad de estos resultados y hacer estudios de costo-efectividad antes de recomendar su utilización en el diseño de nuevas estrategias de cribado.

Abstract Introduction: An estimated 6.8-8.9 million people are infected with hepatitis C virus in Latin America, of which less than 1% receives antiviral treatment. Studies so far in Colombia have attempted to determine the prevalence of the disease in some risk groups, thus preventing the identification of other factors potentially involved in the spread of the infection. Objectives: To identify traditional and non-traditional risk factors for chronic hepatitis C in the Colombian Caribbean coast. Materials and methods: This was a case-control study (1:3) matched by health care provider and age (± 10 years) conducted at the primary care level of gastroenterology and hepatology outpatient services. All patients with a positive ELISA underwent a confirmatory viral load test. A multivariate logistic regression analysis identified the independent predictors of infection. Results: Blood transfusion (OR=159.2; 95% CI: 35.4-715; p<0.001) and history of hospitalization before 1994 (OR=4.7; 95% CI: 1.3-17.1; p=0.018) were identified as the only two independent predictors of infection. Conclusion: It is necessary to check the reproducibility of these results and to conduct cost-effectiveness studies before recommending their use in the design of new screening strategies.