A comprehensive analysis of transfusion trends and patient outcomes in blood utilization practices at Jimma university medical center

In resource-limited settings like Ethiopia, ensuring adequate blood availability and optimizing its use remain a significant challenge. Comprehensive studies on blood utilization practices are essential for minimizing unnecessary transfusions and enhancing transfusion services, yet such research remains limited. This study aimed to systematically evaluate the efficiency of blood utilization, analyse transfusion trends, and assess patient outcomes. A prospective cross-sectional study was conducted at the largest referral hospital in Southwest Ethiopia, from June 1 to August 30, 2023. Data were collected through consecutive sampling via a standardized checklist. Of the 1,890 blood units requested, 1,608 transfusions were administered to 846 patients, predominantly young individuals and women. The cross-match-to transfusion ratio was 1.175 (range: 1.1-1.24), with a transfusion probability of 85% (100% across all departments) and a transfusion index of 1.9 (range: 1.41-2.33). The overall utilization rate was 85%, with the highest transfusion needs observed in the medical and obstetrics & gynaecology wards, although the latter also had the highest un-utilization rate. Anaemia (unspecified) was the primary indication for transfusion, and whole blood was the most frequently used product despite various clinical indications. Post-transfusion haematological parameters improved significantly (p < 0.0001). Component transfusions were associated with better patient outcomes (AOR = 2.427, 95% CI: 1.531-3.846, P = 0.001), and prescriptions by senior physicians resulted in improved outcomes (AOR = 2.842, 95% CI: 1.058-7.636, P = 0.038). Overall, 81.4% of patients showed improvement following transfusions, while immediate non-haemolytic immunological transfusion reactions occurred in 1.1% of patients. Despite low intention to adopt evidence-based transfusion strategies in our study setting, the implications are profound. This study highlights the critical need for improved adherence to clinical guidelines and protocols for more effective blood utilization.