目的:输血相关不良事件与供体特征有关。性别是否存在不确定性,特别是献血者的怀孕史,可能会影响患者的预后。还研究了血液制品的储存时间是否对患者的预后很重要。和新鲜产品的小的有害影响仍然是一种可能性。这里,我们假设,在男性患者中,从未怀孕的献血者捐献的新鲜红细胞产品与死亡率相关.
方法:我们使用了2005年至2015年在荷兰接受首次输血的成年患者的队列研究数据。接受五种暴露类别之一的输血后死亡风险(从未怀孕的女性储存≤10天,从未怀孕的女性储存>10天,女性怀孕存放≤10天,女性怀孕储存>10天,男性储存≤10天),与接受男性捐赠者捐赠的单位相比,储存时间>10天(参考),使用Cox比例风险模型计算。
结果:该研究包括42,456名患者,总共贡献了88,538人年,其中13,948人在研究随访期间死亡(33%)。来自曾经怀孕的捐献者的新鲜单位(储存≤10天)与男性患者的死亡率相关,但相关性无统计学意义(风险比1.39,95%置信区间0.97-1.99).敏感性分析没有证实这一发现。
结论:这些发现并不一致地支持以下观点,即观察到的妊娠供血者单位与死亡率之间的关联是由血液产品储存介导的。
OBJECTIVE: Donor characteristics have been implicated in transfusion-related adverse events. Uncertainty remains about whether sex, and specifically pregnancy history of the blood donor, could affect patient outcomes. Whether storage duration of the blood product could be important for patient outcomes has also been investigated, and a small detrimental effect of fresh products remains a possibility. Here, we hypothesize that fresh red blood cell products donated by ever-pregnant donors are associated with mortality in male patients.
METHODS: We used data from a cohort study of adult patients receiving a first transfusion between 2005 and 2015 in the Netherlands. The risk of death after receiving a transfusion from one of five exposure categories (female never-pregnant stored ≤10 days, female never-pregnant stored >10 days, female ever-pregnant stored ≤10 days, female ever-pregnant stored >10 days and male stored for ≤10 days), compared to receiving a unit donated by a male donor, which was stored for >10 days (reference), was calculated using a Cox proportional hazards model.
RESULTS: The study included 42,456 patients who contributed 88,538 person-years in total, of whom 13,948 died during the follow-up of the study (33%). Fresh units (stored for ≤10 days) from ever-pregnant donors were associated with mortality in male patients, but the association was not statistically significant (hazard ratio 1.39, 95% confidence interval 0.97-1.99). Sensitivity analyses did not corroborate this finding.
CONCLUSIONS: These findings do not consistently support the notion that the observed association between ever-pregnant donor units and mortality is mediated by blood product storage.