# Analysis of influencing factors for 5-year transfusion-related adverse events in a tertiary hospital using real-world data

## TL;DR

This study identifies risk factors for transfusion-related adverse events over five years in a hospital, aiming to improve patient safety through better monitoring and strategies.

## Contribution

The study uses real-world data to identify independent risk factors for transfusion-related adverse events in a tertiary hospital setting.

## Key findings

- Older age, more prior transfusions, and comorbidities like hypertension and cancer are independent risk factors for TrAEs.
- Higher transfusion volumes and internal medicine department patients are associated with increased TrAE risk.
- TrAE patients had higher post-transfusion vital signs and longer hospital stays compared to controls.

## Abstract

Transfusion-related adverse events (TrAEs), though relatively uncommon, significantly impact patient safety, with multifactorial mechanisms necessitating risk identification through real-world data.

This study aimed to identify independent risk factors for TrAEs over a 5-year period in a tertiary hospital to inform clinical prevention strategies.

A retrospective case-control study was conducted from January 2020 to December 2024, including 84 patients with documented TrAEs and 336 matched controls without reactions. Data on demographics, transfusion history, blood product attributes, vital signs, laboratory parameters, and outcomes were extracted from hospital records. Multivariate logistic regression was used to identify independent risk factors.

The observation group exhibited significantly higher values in age, number of prior transfusions, and prevalence of hypertension, diabetes mellitus, cardiovascular disease, and malignancy compared to the control group (P < 0.05). Patients in the internal medicine department had a higher risk of TARs than those in other departments (P < 0.05). Regarding transfusion characteristics, the transfusion volume in the observation group was significantly higher than that in the control group (P < 0.05). At 1-h post-transfusion, body temperature, heart rate, respiratory rate, systolic blood pressure, white blood cell count, and C-reactive protein in the observation group were significantly higher, while hemoglobin levels were lower than those in the control group (P < 0.05). In terms of clinical management, the observation group showed significantly higher rates of antipyretic-analgesic use, corticosteroid use, ICU admission, and longer hospital stays compared to the control group (P < 0.05). Multivariate logistic regression analysis identified increasing age, higher number of prior transfusions, comorbidities of hypertension, cardiovascular disease, malignancy, and larger transfusion volume as independent risk factors for TARs (P < 0.05).

TrAEs are influenced by patient age, transfusion history, comorbidities, and transfusion volume. Enhanced monitoring and tailored transfusion strategies are recommended for high-risk patients to improve safety.