Designing and testing a computer-based screening system for transfusion-related acute lung injury.
Computer-based systems can detect underreported adverse events. We hypothesized that a system could be designed to detect potential or unreported cases of transfusion-related acute lung injury (TRALI). We developed and tested a computer screening system using retrospective computer blood gas data after transfusions during a 45-day period at a tertiary care academic hospital. The program identified cases of posttransfusion hypoxemia. Medical records of identified cases were reviewed to diagnose TRALI. During the 45-day period, 820 patients received 6,888 blood products. Seven cases of TRALI were diagnosed, whereas only 2 had been reported. The system had 99% accuracy and 26% positive predictive value for detecting potential TRALI. Computer screening finds more cases of TRALI than are reported voluntarily, and a prospective study using this system is feasible and needed to validate this method of detecting this important adverse transfusion reaction.
Finlay
Heather E
HE
Department of Laboratory Medicine, University of California, San Francisco, CA 94143, USA.
Cassorla
Lydia
L
Feiner
John
J
Toy
Pearl
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis; D001787:Blood Group Incompatibility / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D002140:California / Q000453:epidemiology; D002648:Child; D003199:Computer Systems; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008499:Medical Records; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D017751:Safety Management / Q000379:methods*; D065227:Transfusion Reaction