전자의무기록자료를 활용한 수혈이상반응 보고시스템 = Reporting System of Transfusion Adverse Reaction Using Electronic Medical Records Data

다국어 초록 (Multilingual Abstract)

Background: Rapid and sensitive detection of transfusion adverse reaction is fundamental to reducing transfusion-related morbidity and mortality. The aim of this study was to develop an effective system for reporting of transfusion adverse reaction.
Methods: Inpatient lists with transfusion adverse reaction on a nurse electronic medical records (EMR) from December 4th, 2014 to May 21st, 2015 were automatically selected and displayed to the computer screen of the blood bank data management system. After review of clinical and laboratory data of suspected patients with transfusion reaction, frequency of transfusion adverse reaction according to blood components was calculated.
Results: The frequency of transfusion adverse reactions according to blood components was, in decreasing order, red blood cells (RBC) 0.91% (58/6,404), frozen fresh plasma (FFP) 0.20% (5/2,549), and platelets 0.10% (6/5,728). Of 47 allergic reactions, the relative ratio by blood components was RBC 76.6%, platelets 12.8%, and FFP 10.6%. All of 22 febrile nonhemolytic transfusion reactions were RBC related reactions.
Conclusion: The online transfusion adverse reaction reporting system based on a nurse EMR is helpful in easy and accurate estimation of transfusion adverse reaction incidence.

국문 초록 (Abstract)

배경: 수혈 반응의 빠르고 정확한 선별은 수혈이상반응으로 인한 이환율과 사망률 감소에 중요한 역학을 한다. 이번 연구는 효율적인 수혈 이상반응 보고 체계의 구축을 목표로 하였다.
방법: 2014년 12월 4일부터 2015년 5월 21일 까지 입원 환자의 수혈 관련 증상은 간호 전자의무기록에서 자동적으로 선별되고 혈액 은행 정보관리 시스템 화면에 표시되도록 수혈이상반응보고 체계를 구축하였다. 보고 체계를 통하여 진단검사의사는 수혈이상반응 유무를 판정하였고, 연구 기간 동안 출고된 총 혈액제제의 수혈후이상반응의 빈도를 구하였다.
결과: 수혈이상반응 중에서 혈액성분제제별빈도는 적혈구농축액 0.91% (58/6,404), 신선동결혈장 0.20% (5/2,549), 농축혈소판 0.10% (6/5,728) 의 순이었다. 총 47건의 알레르기 이상반응 중 적혈구는 76.6%, 혈소판은 12.8%, 신선동결혈장은10.6%이었다. 발열성 비용혈수혈부작용 22건은모두 농축적혈구 제제에서 발생하였다.
결론: 간호 전자의무기록을 기반으로 한 온라인 수혈반응 보고시스템은 간편하고 정확하게 수혈이상반응의 빈도를 파악하는데 도움을 주었다.

참고문헌 (Reference)

1 Harvey AR., "Transfusion-related adverse reactions reported to the National Healthcare Safety Network Hemovigilance Module, United States, 2010 to 2012" 55 : 709-718, 2015

2 Korea centers for disease control and prevention, "Study on the improvement of hemovigilance surveillance system"

3 Korea centers for disease control and prevention, "Monthly report (2015.04)"

4 Torres R., "Diagnosis, treatment, and reporting of adverse effects of transfusion" 43 : 217-231, 2012

5 Korea centers for disease control and prevention, "Development of hemovigilance system in Korea (2nd year)"

6 Yeh SP., "A well-designed online transfusion reaction reporting system improves the estimation of transfusion reaction incidence and quality of care in transfusion practice" 136 : 842-847, 2011