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Association of Blood Donor Sex and Prior Pregnancy With Mortality Among Red Blood Cell Transfusion Recipients

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NHLBI Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) Group. / Association of Blood Donor Sex and Prior Pregnancy With Mortality Among Red Blood Cell Transfusion Recipients. I: JAMA - Journal of the American Medical Association. 2019 ; Bind 321, Nr. 22. s. 2183-2192.

Bibtex

@article{9686292a6dd54840b9056fbafa666f25,
title = "Association of Blood Donor Sex and Prior Pregnancy With Mortality Among Red Blood Cell Transfusion Recipients",
abstract = "Importance: Evidence regarding associations of blood donor sex with mortality among red blood cell transfusion recipients is conflicting.Objective: To study associations of donor sex and prior pregnancy with mortality of transfusion recipients.Design, Setting, and Participants: Data from 3 retrospective cohorts of transfusion recipients (the Kaiser Permanente Northern California [KPNC] and Recipient Epidemiology and Donor Evaluation Study-III [REDS-III] databases of data from January 2013 to December 2016 and the Scandinavian Donations and Transfusions [SCANDAT] database with data from January 2003 to December 2012) were analyzed. Final dates of follow-up were December 31, 2016, for the KPNC and REDS-III cohorts and December 31, 2012, for the SCANDAT cohort. Stratified Cox regression models were used to estimate associations between donor exposure groups with risk of mortality, adjusting for the number of red blood cell unit transfusions.Exposures: The number of transfused red blood cell units from female donors, previously pregnant donors, and sex-discordant donors (male donor and female recipient or female donor and male recipient).Main Outcomes and Measures: In-hospital mortality.Results: The study population included 34 662 patients (mean age, 69 years; 18 652 [54{\%}] women) from the KPNC cohort, 93 724 patients (mean age, 61 years; 48 348 [52{\%}] women) from the REDS-III cohort, and 918 996 patients (mean age, 72 years; 522 239 [57{\%}] women) from the SCANDAT cohort. The median number of red blood cell transfusions per patient was 3 in the KPNC cohort, 2 in the REDS-III cohort, and 3 in the SCANDAT cohort. The percentage of transfusions from previously pregnant or parous donors was 9{\%} in the KPNC cohort, 18{\%} in the REDS-III cohort, and 25{\%} in the SCANDAT cohort. The percentage of transfusions in the 3 cohorts from female donors ranged from 39{\%} to 43{\%}, from previously pregnant or parous donors ranged from 9{\%} to 25{\%}, and from sex-discordant donors ranged from 44{\%} to 50{\%}. There were 3217 in-hospital deaths in the KPNC cohort, 8519 in the REDS-III cohort, and 198 537 in the SCANDAT cohort. There were no statistically significant associations between any of the 3 donor exposures and in-hospital mortality in the 3 cohorts. Hazard ratios for in-hospital mortality per transfused unit from female donors were 0.99 (95{\%} CI, 0.96-1.03) for the KPNC cohort, 1.00 (95{\%} CI, 0.99-1.01) for the REDS-III cohort, and 1.00 (95{\%} CI, 0.99-1.00) for the SCANDAT cohort. For units from previously pregnant or parous female donors, hazard ratios were 1.00 (95{\%} CI, 1.00-1.01) for the KPNC cohort, 1.01 (95{\%} CI, 0.98-1.03) for the REDS-III cohort, and 1.00 (95{\%} CI, 1.00-1.01) for the SCANDAT cohort. For units from sex-discordant transfusions, hazard ratios were 1.02 (95{\%} CI, 0.99-1.05) for the KPNC cohort, 0.99 (95{\%} CI, 0.98-1.00) for the REDS-III cohort, and 1.00 (95{\%} CI, 0.99-1.00) for the SCANDAT cohort.Conclusions and Relevance: Among red blood cell transfusion recipients, transfusions from female, previously pregnant, or sex-discordant donors were not significantly associated with increased mortality.",
keywords = "Adult, Aged, Blood Donors, Cohort Studies, Databases, Factual, Erythrocyte Transfusion/mortality, Female, Humans, Male, Middle Aged, Pregnancy, Retrospective Studies, Risk Factors, Sex Factors, Survival Analysis, Transplantation Immunology, Young Adult",
author = "Gustaf Edgren and Murphy, {Edward L} and Brambilla, {Don J} and Matt Westlake and Klaus Rostgaard and Catherine Lee and Cable, {Ritchard G} and Darrell Triulzi and Roberta Bruhn and {St Lezin}, {Elizabeth M} and Christian Erikstrup and Henrik Ullum and Glynn, {Simone A} and Steve Kleinman and Henrik Hjalgrim and Roubinian, {Nareg H} and {NHLBI Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) Group}",
year = "2019",
month = "6",
day = "11",
doi = "10.1001/jama.2019.7084",
language = "English",
volume = "321",
pages = "2183--2192",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "22",

}

RIS

TY - JOUR

T1 - Association of Blood Donor Sex and Prior Pregnancy With Mortality Among Red Blood Cell Transfusion Recipients

AU - Edgren, Gustaf

AU - Murphy, Edward L

AU - Brambilla, Don J

AU - Westlake, Matt

AU - Rostgaard, Klaus

AU - Lee, Catherine

AU - Cable, Ritchard G

AU - Triulzi, Darrell

AU - Bruhn, Roberta

AU - St Lezin, Elizabeth M

AU - Erikstrup, Christian

AU - Ullum, Henrik

AU - Glynn, Simone A

AU - Kleinman, Steve

AU - Hjalgrim, Henrik

AU - Roubinian, Nareg H

AU - NHLBI Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) Group

PY - 2019/6/11

Y1 - 2019/6/11

N2 - Importance: Evidence regarding associations of blood donor sex with mortality among red blood cell transfusion recipients is conflicting.Objective: To study associations of donor sex and prior pregnancy with mortality of transfusion recipients.Design, Setting, and Participants: Data from 3 retrospective cohorts of transfusion recipients (the Kaiser Permanente Northern California [KPNC] and Recipient Epidemiology and Donor Evaluation Study-III [REDS-III] databases of data from January 2013 to December 2016 and the Scandinavian Donations and Transfusions [SCANDAT] database with data from January 2003 to December 2012) were analyzed. Final dates of follow-up were December 31, 2016, for the KPNC and REDS-III cohorts and December 31, 2012, for the SCANDAT cohort. Stratified Cox regression models were used to estimate associations between donor exposure groups with risk of mortality, adjusting for the number of red blood cell unit transfusions.Exposures: The number of transfused red blood cell units from female donors, previously pregnant donors, and sex-discordant donors (male donor and female recipient or female donor and male recipient).Main Outcomes and Measures: In-hospital mortality.Results: The study population included 34 662 patients (mean age, 69 years; 18 652 [54%] women) from the KPNC cohort, 93 724 patients (mean age, 61 years; 48 348 [52%] women) from the REDS-III cohort, and 918 996 patients (mean age, 72 years; 522 239 [57%] women) from the SCANDAT cohort. The median number of red blood cell transfusions per patient was 3 in the KPNC cohort, 2 in the REDS-III cohort, and 3 in the SCANDAT cohort. The percentage of transfusions from previously pregnant or parous donors was 9% in the KPNC cohort, 18% in the REDS-III cohort, and 25% in the SCANDAT cohort. The percentage of transfusions in the 3 cohorts from female donors ranged from 39% to 43%, from previously pregnant or parous donors ranged from 9% to 25%, and from sex-discordant donors ranged from 44% to 50%. There were 3217 in-hospital deaths in the KPNC cohort, 8519 in the REDS-III cohort, and 198 537 in the SCANDAT cohort. There were no statistically significant associations between any of the 3 donor exposures and in-hospital mortality in the 3 cohorts. Hazard ratios for in-hospital mortality per transfused unit from female donors were 0.99 (95% CI, 0.96-1.03) for the KPNC cohort, 1.00 (95% CI, 0.99-1.01) for the REDS-III cohort, and 1.00 (95% CI, 0.99-1.00) for the SCANDAT cohort. For units from previously pregnant or parous female donors, hazard ratios were 1.00 (95% CI, 1.00-1.01) for the KPNC cohort, 1.01 (95% CI, 0.98-1.03) for the REDS-III cohort, and 1.00 (95% CI, 1.00-1.01) for the SCANDAT cohort. For units from sex-discordant transfusions, hazard ratios were 1.02 (95% CI, 0.99-1.05) for the KPNC cohort, 0.99 (95% CI, 0.98-1.00) for the REDS-III cohort, and 1.00 (95% CI, 0.99-1.00) for the SCANDAT cohort.Conclusions and Relevance: Among red blood cell transfusion recipients, transfusions from female, previously pregnant, or sex-discordant donors were not significantly associated with increased mortality.

AB - Importance: Evidence regarding associations of blood donor sex with mortality among red blood cell transfusion recipients is conflicting.Objective: To study associations of donor sex and prior pregnancy with mortality of transfusion recipients.Design, Setting, and Participants: Data from 3 retrospective cohorts of transfusion recipients (the Kaiser Permanente Northern California [KPNC] and Recipient Epidemiology and Donor Evaluation Study-III [REDS-III] databases of data from January 2013 to December 2016 and the Scandinavian Donations and Transfusions [SCANDAT] database with data from January 2003 to December 2012) were analyzed. Final dates of follow-up were December 31, 2016, for the KPNC and REDS-III cohorts and December 31, 2012, for the SCANDAT cohort. Stratified Cox regression models were used to estimate associations between donor exposure groups with risk of mortality, adjusting for the number of red blood cell unit transfusions.Exposures: The number of transfused red blood cell units from female donors, previously pregnant donors, and sex-discordant donors (male donor and female recipient or female donor and male recipient).Main Outcomes and Measures: In-hospital mortality.Results: The study population included 34 662 patients (mean age, 69 years; 18 652 [54%] women) from the KPNC cohort, 93 724 patients (mean age, 61 years; 48 348 [52%] women) from the REDS-III cohort, and 918 996 patients (mean age, 72 years; 522 239 [57%] women) from the SCANDAT cohort. The median number of red blood cell transfusions per patient was 3 in the KPNC cohort, 2 in the REDS-III cohort, and 3 in the SCANDAT cohort. The percentage of transfusions from previously pregnant or parous donors was 9% in the KPNC cohort, 18% in the REDS-III cohort, and 25% in the SCANDAT cohort. The percentage of transfusions in the 3 cohorts from female donors ranged from 39% to 43%, from previously pregnant or parous donors ranged from 9% to 25%, and from sex-discordant donors ranged from 44% to 50%. There were 3217 in-hospital deaths in the KPNC cohort, 8519 in the REDS-III cohort, and 198 537 in the SCANDAT cohort. There were no statistically significant associations between any of the 3 donor exposures and in-hospital mortality in the 3 cohorts. Hazard ratios for in-hospital mortality per transfused unit from female donors were 0.99 (95% CI, 0.96-1.03) for the KPNC cohort, 1.00 (95% CI, 0.99-1.01) for the REDS-III cohort, and 1.00 (95% CI, 0.99-1.00) for the SCANDAT cohort. For units from previously pregnant or parous female donors, hazard ratios were 1.00 (95% CI, 1.00-1.01) for the KPNC cohort, 1.01 (95% CI, 0.98-1.03) for the REDS-III cohort, and 1.00 (95% CI, 1.00-1.01) for the SCANDAT cohort. For units from sex-discordant transfusions, hazard ratios were 1.02 (95% CI, 0.99-1.05) for the KPNC cohort, 0.99 (95% CI, 0.98-1.00) for the REDS-III cohort, and 1.00 (95% CI, 0.99-1.00) for the SCANDAT cohort.Conclusions and Relevance: Among red blood cell transfusion recipients, transfusions from female, previously pregnant, or sex-discordant donors were not significantly associated with increased mortality.

KW - Adult

KW - Aged

KW - Blood Donors

KW - Cohort Studies

KW - Databases, Factual

KW - Erythrocyte Transfusion/mortality

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Pregnancy

KW - Retrospective Studies

KW - Risk Factors

KW - Sex Factors

KW - Survival Analysis

KW - Transplantation Immunology

KW - Young Adult

U2 - 10.1001/jama.2019.7084

DO - 10.1001/jama.2019.7084

M3 - Journal article

VL - 321

SP - 2183

EP - 2192

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 22

ER -

ID: 58006924