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Adverse Occurrence type:
Overall TRALI rates 22.46 per 100,000 stays increasing form 14.40 in 2007 to 34.84 in 2011 attributed to increased awareness of TRALI. The rates for RBC's, plasma, and platelets are 16.51, 31.37, and 47.28, respectively with rates for these components decreasing 2011 vs. 2010. In-patient mortality for patients with TRALI= 21.0% vs. 7.2% for patients without TRALI. OR for TRALI in 65-79 year olds =1.19 compared to those > 79 years. Females at greater risk than males (OR= 1.26). Six-month history of pulmonary fibrosis and tobacco use higher in TRALI patients (OR= 1.89 and 1.16, respectively). Also higher in patients with malignancies. Odds of TRALI increase with the number of units transfused.
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
ICD-9-CM dianosis code 518.7 used to screen Medicare records for TRALI
Demonstration of imputability or root cause:
Retrospective record review
Menis M, Anderson SA, Forshee RA, McKean S, Johnson C, Warnock R, Gondalia R, Mintz PD, Holness L, Worrall CM, Kelman JA, Izurieta HS. Transfusion-related acute lung injury and potential risk factors among the inpatient US elderly as recorded in Medicare claims data, during 2007 through 2011. Transfusion. 2014;54:2182-93.
Expert comments for publication:
11,378,264 in-patient stays for Medicare patients (>65 years) reviewed. Retospective claims-based cohort study.