Mortality‐associated risk factors for transfusion‐associated circulatory overload

Author:

Soni Lipika1,Saeed Samia2,Cserti‐Gazdewich Christine23456ORCID,McVey Mark J.1789ORCID

Affiliation:

1. Department of Anesthesia and Pain Medicine Hospital for Sick Children Toronto Ontario Canada

2. Department of Laboratory Medicine & Pathobiology University Health Network Toronto Ontario Canada

3. Blood Transfusion Laboratory (Laboratory Medicine Program), Toronto General Hospital University Health Network Toronto Ontario Canada

4. Department of Medicine (Medical Oncology & Hematology) University Health Network Toronto Ontario Canada

5. Division of Hematology, Department of Medicine University of Toronto Toronto Ontario Canada

6. Utilization, Efficacy, & Safety of Transfusion (QUEST) Research Program University of Toronto Quality Toronto Ontario Canada

7. Department of Physics Toronto Metropolitan University Toronto Ontario Canada

8. Department of Anesthesiology and Pain Medicine University of Toronto Toronto Ontario Canada

9. Department of Physiology University of Toronto Toronto Ontario Canada

Abstract

AbstractBackground and ObjectivesRespiratory transfusion reactions associate strongly with morbidity and mortality, and transfusion‐associated circulatory overload (TACO) is the leading cause of reaction‐related deaths. Risk factors for TACO include transfusion speed and volume and cardiorenal comorbidities.Materials and MethodsAn academic health network haemovigilance database was interrogated to assess variables associating with 371 cases of TACO and involved‐visit outcomes, using univariate and multivariate regression analysis.ResultsTACO reactions over 11 years were reported in 179 males and 192 females, median age (interquartile range) 65 (53–75) years. In‐hospital and 28‐day mortality were 17.5% and 12.9%, respectively. In univariate regression modelling, male sex, injury severity grade, product volume administered, the use of platelets and intensive care admissions were each associated with in‐hospital and 28‐day mortality (p < 0.05). However, after multivariate regression analysis, only male sex in transfusion recipients independently associated with mortality (p < 0.05).ConclusionIn this cohort, male recipient sex and platelet administration were associated with TACO‐involving admissions not ending in survival.

Publisher

Wiley

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