An Analysis and Evaluation of Causal Factors of Failure Results and Corresponding Solutions in 447 Cases of ABO Blood Type Identification Auto-audit
Objective To analyze the causal and influencing factors in 477 cases of ABO blood type identification auto-audit failures,and to preliminarily establish corresponding processing procedures. Methods Referring to the criteria for automatic audit of quantitative test results in clinical laboratories (WS/T 616-2018),we formulated automatic audit rules for ABO blood type identification in our department.Clinical data of a total of 477 patients with ABO blood type identification auto-audit failures at Peking Union Medical College Hospital Laboratory Department,from January,2021 to December,2022,were collected for the study.The causal factors for ABO blood type identification failure were analyzed,and corresponding processing procedures were established in conjunction with the clinical diagnostic characteristics of these patients.Results Patients were categorized by causes:79 cases were due to antigens,of whom:50 cases involved weakened or absent antigens,while 29 cases were subtypes;398 cases were due to antibodies,of whom:305 cases involved weakened/absent serum antibodies,23 cases involved cold agglutinins (cold antibodies)/27 cases involved autoantibodies,and 43cases involved red blood cell alloantibodies.According to the types of diseases suffered by these patients,results showed:tumors accounted for 94 cases,or 19.7％;hematologic diseases accounted for 59 cases,or 12.4％;autoimmune diseases accounted for 43 cases,or 9％;endocrine diseases accounted for 25 cases,or 5.2％;gynecological diseases and pregnancy accounted for 72 cases,or 15.1％;other diseases accounted for 184 cases,or 38.6％.Conclusion Among 477 cases of ABO blood type identification auto-audit failures,physiological changes caused by age-related changes are the most common cause.In addition,irregular antibodies,ABO subtypes,and weakened antigens can also lead to this result.In blood type identification process,patient 's status should be comprehensively considered,and appropriate auxiliary experimental methods should be selected to improve the accuracy of ABO blood type identification and ensure the safety of clinical blood transfusions.
ABO blood type identification auto-auditReasons for failureIdentificationSolutions
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