The association of donor and recipient sex on sepsis rates and hemoglobin increment among critically ill patients receiving red cell transfusions in a retrospective study

Abstract Background Existing research presents conflicting results on the influence of blood donor sex on hemoglobin (Hb) change and transfusion‐associated infection and mortality in transfusion recipients. Aim This retrospective study explored the association between donor and recipient sex on hosp...

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Main Authors: Wenhui Li, Yang Liu, Kayla J. Lucier, Nancy M. Heddle, Jason P. Acker
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:eJHaem
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Online Access:https://doi.org/10.1002/jha2.1005
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author Wenhui Li
Yang Liu
Kayla J. Lucier
Nancy M. Heddle
Jason P. Acker
author_facet Wenhui Li
Yang Liu
Kayla J. Lucier
Nancy M. Heddle
Jason P. Acker
author_sort Wenhui Li
collection DOAJ
description Abstract Background Existing research presents conflicting results on the influence of blood donor sex on hemoglobin (Hb) change and transfusion‐associated infection and mortality in transfusion recipients. Aim This retrospective study explored the association between donor and recipient sex on hospital‐onset sepsis (HO‐sepsis) and Hb changes in critically ill patients receiving red blood cell (RBC) transfusions. Methods Data from 2010–2020 were extracted from an academic hospital's clinical database and a blood supplier's donor database. HO‐sepsis was determined based on the International Classification of Diseases and Related Health Problems 10th Revision (ICD‐10) diagnostic codes without requiring a microbiology test within the first 48 h of admission. Hb increments were determined by comparing the last Hb result in the 24‐h period prior to RBC unit issue and the first Hb result within 4–24 h after RBC unit issued for transfusion. Results 25,585 critically ill patients received one or more RBC transfusions; 3,410 were included in the HO‐sepsis and 3,487 in the Hb increment analysis. There was no significant differences in the HO‐sepsis rate among the four groups, but female recipients were more prone to HO‐sepsis than males (OR 1.48, p = 0.04). Multivariate analysis found that the number of RBC unit transfused (p = 0.001) and recipient age (p = 0.03), but not recipient sex (p = 0.63), were significant contributors to HO‐sepsis. Male blood was associated with higher Hb than female blood in female recipients (p = 0.007), but not in male recipients (p = 0.75). Variables such as donor Hb levels and recipient Hb level influenced Hb increments. Conclusion Blood donor sex was not associated with HO‐sepsis in critically ill patients receiving RBC transfusion. Male to female transfusions were associated with a higher Hb increment in recipients. Further exploration of the impact of sex mis‐matched transfusion on recipient outcomes is warranted.
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spelling doaj-art-9d03b6def57c4e7e96edc6cf6703e9f62025-08-20T02:58:00ZengWileyeJHaem2688-61462025-02-0161n/an/a10.1002/jha2.1005The association of donor and recipient sex on sepsis rates and hemoglobin increment among critically ill patients receiving red cell transfusions in a retrospective studyWenhui Li0Yang Liu1Kayla J. Lucier2Nancy M. Heddle3Jason P. Acker4Department of Laboratory Medicine and Pathology University of Alberta Edmonton Alberta CanadaMichael G. DeGroote Centre for Transfusion Research McMaster University Hamilton Ontario CanadaMichael G. DeGroote Centre for Transfusion Research McMaster University Hamilton Ontario CanadaMichael G. DeGroote Centre for Transfusion Research McMaster University Hamilton Ontario CanadaDepartment of Laboratory Medicine and Pathology University of Alberta Edmonton Alberta CanadaAbstract Background Existing research presents conflicting results on the influence of blood donor sex on hemoglobin (Hb) change and transfusion‐associated infection and mortality in transfusion recipients. Aim This retrospective study explored the association between donor and recipient sex on hospital‐onset sepsis (HO‐sepsis) and Hb changes in critically ill patients receiving red blood cell (RBC) transfusions. Methods Data from 2010–2020 were extracted from an academic hospital's clinical database and a blood supplier's donor database. HO‐sepsis was determined based on the International Classification of Diseases and Related Health Problems 10th Revision (ICD‐10) diagnostic codes without requiring a microbiology test within the first 48 h of admission. Hb increments were determined by comparing the last Hb result in the 24‐h period prior to RBC unit issue and the first Hb result within 4–24 h after RBC unit issued for transfusion. Results 25,585 critically ill patients received one or more RBC transfusions; 3,410 were included in the HO‐sepsis and 3,487 in the Hb increment analysis. There was no significant differences in the HO‐sepsis rate among the four groups, but female recipients were more prone to HO‐sepsis than males (OR 1.48, p = 0.04). Multivariate analysis found that the number of RBC unit transfused (p = 0.001) and recipient age (p = 0.03), but not recipient sex (p = 0.63), were significant contributors to HO‐sepsis. Male blood was associated with higher Hb than female blood in female recipients (p = 0.007), but not in male recipients (p = 0.75). Variables such as donor Hb levels and recipient Hb level influenced Hb increments. Conclusion Blood donor sex was not associated with HO‐sepsis in critically ill patients receiving RBC transfusion. Male to female transfusions were associated with a higher Hb increment in recipients. Further exploration of the impact of sex mis‐matched transfusion on recipient outcomes is warranted.https://doi.org/10.1002/jha2.1005blood transfusionhemoglobin incrementintensive care unitsepsis
spellingShingle Wenhui Li
Yang Liu
Kayla J. Lucier
Nancy M. Heddle
Jason P. Acker
The association of donor and recipient sex on sepsis rates and hemoglobin increment among critically ill patients receiving red cell transfusions in a retrospective study
eJHaem
blood transfusion
hemoglobin increment
intensive care unit
sepsis
title The association of donor and recipient sex on sepsis rates and hemoglobin increment among critically ill patients receiving red cell transfusions in a retrospective study
title_full The association of donor and recipient sex on sepsis rates and hemoglobin increment among critically ill patients receiving red cell transfusions in a retrospective study
title_fullStr The association of donor and recipient sex on sepsis rates and hemoglobin increment among critically ill patients receiving red cell transfusions in a retrospective study
title_full_unstemmed The association of donor and recipient sex on sepsis rates and hemoglobin increment among critically ill patients receiving red cell transfusions in a retrospective study
title_short The association of donor and recipient sex on sepsis rates and hemoglobin increment among critically ill patients receiving red cell transfusions in a retrospective study
title_sort association of donor and recipient sex on sepsis rates and hemoglobin increment among critically ill patients receiving red cell transfusions in a retrospective study
topic blood transfusion
hemoglobin increment
intensive care unit
sepsis
url https://doi.org/10.1002/jha2.1005
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