TY - JOUR
T1 - Oncology Patients Who Develop Transfusion-Associated Circulatory Overload
T2 - An Observational Study
AU - Maldonado, Marisol
AU - Villamin, Colleen E.
AU - Murphy, Leah E.
AU - Dasgupta, Amitava
AU - Bassett, Roland L.
AU - Correa Medina, Mayrin
AU - Bates, Tonita S.
AU - Martinez, Fernando
AU - Knopfelmacher Couchonal, Adriana M.
AU - Klein, Kimberly
AU - Kelley, James M.
N1 - Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Background: Transfusion-associated circulatory overload (TACO) is a largely preventable transfusion complication that results in significant morbidity and mortality. Cancers, related treatments, and comorbidities are among the factors that can predispose patients to TACO, but currently there are limited data on this topic in the literature. Methods: We collected data retrospectively from the electronic health records of 93 adult patients with cancer who met Centers for Disease Control and Prevention (CDC) criteria for TACO from July 1, 2019, through October 31, 2020. The parameters we studied included demographics, comorbidities, treatment modalities, transfusion practices, and outcomes. We summarized data by means and ranges for continuous variables, and proportions for categorical variables. Results: During the study period, the incidence of TACO among oncology patients was 0.84 per 1000 transfusions (95% CI, 0.68–1.02), representing 6.6% of all reactions. This percentage is high, compared with 1%–6% among other populations. Unique characteristics such as hematology malignancy (75.3%), receipt of cardiotoxic chemotherapy (87.1%), pneumonia (57.0%), preexisting oxygen use (59.1%), dyspnea (62.4%), hypertension (55.9%), renal insufficiency (46.2%), daily use of corticosteroids (43.0%), daily use of diuretics (40.9%), daily use of beta-blockers (36.6%), and elevated NT-proBNP (33.3%) were frequently observed in these group of oncology patients. Conclusions: Our study indicates that oncology patients have unique factors that may lead to diagnosis of TACO. Developing appropriate guidelines that apply to oncology patients, in addition to those set forth by the CDC, should be considered. Implementation by ordering healthcare providers of a tools that can predict TACO can help in early recognition and mitigation of TACO.
AB - Background: Transfusion-associated circulatory overload (TACO) is a largely preventable transfusion complication that results in significant morbidity and mortality. Cancers, related treatments, and comorbidities are among the factors that can predispose patients to TACO, but currently there are limited data on this topic in the literature. Methods: We collected data retrospectively from the electronic health records of 93 adult patients with cancer who met Centers for Disease Control and Prevention (CDC) criteria for TACO from July 1, 2019, through October 31, 2020. The parameters we studied included demographics, comorbidities, treatment modalities, transfusion practices, and outcomes. We summarized data by means and ranges for continuous variables, and proportions for categorical variables. Results: During the study period, the incidence of TACO among oncology patients was 0.84 per 1000 transfusions (95% CI, 0.68–1.02), representing 6.6% of all reactions. This percentage is high, compared with 1%–6% among other populations. Unique characteristics such as hematology malignancy (75.3%), receipt of cardiotoxic chemotherapy (87.1%), pneumonia (57.0%), preexisting oxygen use (59.1%), dyspnea (62.4%), hypertension (55.9%), renal insufficiency (46.2%), daily use of corticosteroids (43.0%), daily use of diuretics (40.9%), daily use of beta-blockers (36.6%), and elevated NT-proBNP (33.3%) were frequently observed in these group of oncology patients. Conclusions: Our study indicates that oncology patients have unique factors that may lead to diagnosis of TACO. Developing appropriate guidelines that apply to oncology patients, in addition to those set forth by the CDC, should be considered. Implementation by ordering healthcare providers of a tools that can predict TACO can help in early recognition and mitigation of TACO.
KW - blood transfusion
KW - cardio-toxic chemotherapy
KW - oncology patients
KW - outcomes
KW - risk factors
KW - transfusion-associated circulatory overload
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U2 - 10.1093/labmed/lmab119
DO - 10.1093/labmed/lmab119
M3 - Review article
C2 - 35285900
AN - SCOPUS:85134083237
SN - 0007-5027
VL - 53
SP - 344
EP - 348
JO - Lab Medicine
JF - Lab Medicine
IS - 4
ER -