Analysis of influencing factors and related risk factors of transfusion reactions

We collected baseline information and blood product datas for all inpatients who received transfusions at our hospital from January 1, 2020 to December 31, 2025. The analysis examined how patient sex, age, ABO blood type, product type, and storage time of blood products influence the incidence of transfusion reactions.Results From January 1, 2020 to December 31, 2025, among 64,768 cases of inpatient blood transfusions, there were 478 cases of transfusion reactions.The overall incidence was 0.74%.

Among these reactions, allergic reactions accounted for 60.46%, and febrile non-hemolytic transfusion reactions made up 34.73%. The majority of reactions (58.58%) were seen in the hematology department.Patient‑related analysis showed a significantly higher reaction rate in females (0.99%) than in males (0.58%) (P<0.001). For age groups ≤18, 18–60, and >60 years, the incidences were 0.86%, 0.89%, and 0.57%, respectively (P<0.001).

No significant difference was observed across ABO blood types (A 0.79%, B 0.68%, O 0.75%, AB 0.67%, P>0.05).Regarding different types of blood components, the reaction rate was highest for platelets (3.59%), followed by plasma (0.55%) and red blood cells (0.48%) (P<0.001). Fresh frozen plasma had a higher rate (0.66%) than frozen plasma (0.43%) (P<0.05). For different red cell preparations, the incidences were: suspended RBCs 0.60%, irradiated suspended RBCs 0.57%, irradiated leukocyte‑reduced suspended RBCs 0.42%, and leukocyte‑reduced suspended RBCs 0.33% (P>0.05).Analysis of the impact of blood product storage time on transfusion reactions:frozen plasma stored for >180 days gave a reaction rate of 0.68%, significantly higher than ≤180 days (0.36%, P<0.05).

The incidence of transfusion reactions for red blood cell-based blood products with a storage time of more than 21 days was 0.64%, significantly higher than 0.40% for those with a storage time of 21 days or less (P < 0.05). For apheresis platelets, the incidence was 3.40% (>3 days) vs. 3.62% (≤3 days, P>0.05).Multivariate logistic regression identified female sex, age 18–60 years, platelet transfusion, and storage time beyond the respective thresholds as independent predictors for transfusion reactions (all P<0.05).Conclusion The main risk factors for transfusion reactions are patient sex, age, types of blood product, and storage time of the blood product.

Female sex, age 18–60 years, platelet transfusion, storage time beyond the respective thresholds can be regarded as independent predictors of transfusion reactions.