Mortality-associated risk factors for transfusion-associated circulatory overload

Vox Sang. 2024 Sep;119(9):996-1000. doi: 10.1111/vox.13690. Epub 2024 Jun 13.

Abstract

Background and objectives: Respiratory 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 methods: An 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.

Results: TACO 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).

Conclusion: In this cohort, male recipient sex and platelet administration were associated with TACO-involving admissions not ending in survival.

Keywords: ICU; death; mortality; platelets; sex; transfusion‐associated circulatory overload.

MeSH terms

  • Aged
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Platelet Transfusion / adverse effects
  • Risk Factors
  • Sex Factors
  • Transfusion Reaction* / epidemiology