Irradiated red blood cell transfusion is associated with an increased risk of deep vein thrombosis in trauma patients: a case control study

Irradiated red blood cell transfusion is associated with an increased risk of deep vein thrombosis in trauma patients: a case control study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Irradiated red blood cell transfusion is associated with an increased risk of deep vein thrombosis in trauma patients: a case control study Hua Lu, Li-Fang Wu, Jing-Jing Li, Qi Gao, Gui-Ping Xu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3654833/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Gamma ray irradiation accelerates the release of red blood cell (RBC)-derived microparticles with procoagulant function, and further promotes the formation of microthrombosis. The use of irradiated RBCs in nontransplant patients is usually not prohibited, except in patients with renal dysfunction and hyperkalemia. At present, the possibility that irradiated RBC transfusion promotes the occurrence of deep vein thrombosis (DVT) remains unclear. Methods This retrospective cohort study was conducted on 251 trauma patients enrolled between January 2021 and April 2023 at the Second Affiliated Hospital of Chongqing Medical University. The cohort included 147 patients who were only transfused with nonirradiated RBCs (nonirradiation group) and 104 patients who were transfused with irradiated RBCs with or without nonirradiated RBCs (irradiation group). Multivariate logistic regression was used to analyze the risk factors for DVT in this population. Results The incidence of DVT was higher in the irradiation group than in the nonirradiation group (38.5% vs 22.4%, P<0.01). After adjusting for inconsistent variables, the results showed that irradiated RBC transfusion was a significant risk factor for DVT (odds ratio =2.16, 95% confidence interval=1.24 to 3.76; P<0.01). The incidence of DVT increased from 22.4% to 43.8% with the rising percentage of irradiated RBCs in total transfused RBCs (P =0.0248). The median storage days and total units of irradiated RBCs were not associated with an increased risk of DVT (odds ratio 0.05). Further subgroup analysis showed that the total volume, median storage days, and maximum storage days of transfused RBCs were not associated with the occurrence of DVT in this cohort, regardless of whether the irradiation group was included (all, P>0.05). Conclusions Irradiated RBC transfusion was associated with an increased risk of DVT in trauma patients in a percentage-dependent manner, and the total volume and longer storage duration of transfused RBCs were not associated with the incidence of DVT. The transfusion indications for irradiated RBCs should be strictly controlled to avoid unnecessary transfusion of irradiated RBCs to trauma patients. Irradiated red blood cells Blood transfusion Deep vein thrombosis Trauma Figures Figure 1 Figure 2 Figure 3 Full Text Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3654833","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":265713050,"identity":"b4480920-d2a0-48f5-b8d4-fc91f3918c43","order_by":0,"name":"Hua Lu","email":"","orcid":"","institution":"The Second Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Hua","middleName":"","lastName":"Lu","suffix":""},{"id":265713051,"identity":"a7306c3f-a847-4470-8466-c9344947de7c","order_by":1,"name":"Li-Fang Wu","email":"","orcid":"","institution":"The Second Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Li-Fang","middleName":"","lastName":"Wu","suffix":""},{"id":265713052,"identity":"c025a1ee-107d-4942-b54c-a319607efb83","order_by":2,"name":"Jing-Jing Li","email":"","orcid":"","institution":"The Second Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jing-Jing","middleName":"","lastName":"Li","suffix":""},{"id":265713053,"identity":"ecd103b1-3dc3-499c-a412-af15470e3835","order_by":3,"name":"Qi Gao","email":"","orcid":"","institution":"The Second Affiliated Hospital of Chongqing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Qi","middleName":"","lastName":"Gao","suffix":""},{"id":265713054,"identity":"7e5ebf50-e045-492a-a3bb-9816dc4ec826","order_by":4,"name":"Gui-Ping Xu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4UlEQVRIiWNgGAWjYFACxgaGBBDN3gAVOEC0Fh6YUsJaYEAigUgt8hHJbQ8e7qhN3HDz8cNbN9sY5PhuJDB+LsCjxfBGYrtB4pnjxga304ytc9sYjCVvJDBLz8CnZUZim0Ri2zE5g9s5bNJALYkbbiSwMfMQoYXH4OYZsJZ6glrkJcBaauQMbvCAtSQYENJiwPMQ6Je2A8aSZ4B+yTknYTjzzMNmaby2tKc/e/izrS6x7/jhh7dzymzk+Y4nH/yM15YDDGxA6jCYIwFGoMjFB+QbwFrqYFpGwSgYBaNgFGACAN+2Tv9sRqWuAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0002-4811-0052","institution":"The Second Affiliated Hospital of Chongqing Medical University","correspondingAuthor":true,"prefix":"","firstName":"Gui-Ping","middleName":"","lastName":"Xu","suffix":""}],"badges":[],"createdAt":"2023-11-23 14:57:49","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3654833/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3654833/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49386018,"identity":"812592ae-fd38-4394-98e4-dadad7cfd4bd","added_by":"auto","created_at":"2024-01-09 19:52:42","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":37626,"visible":true,"origin":"","legend":"\u003cp\u003eFlow diagram of enrollment process\u003c/p\u003e","description":"","filename":"Figure.1.png","url":"https://assets-eu.researchsquare.com/files/rs-3654833/v1/92dfbc3a0f3ebfa359aceb11.png"},{"id":49386017,"identity":"0808c4a2-80d5-4775-aa0d-cd654a2ef591","added_by":"auto","created_at":"2024-01-09 19:52:42","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":54249,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of storage days of red blood cells transfused to trauma patients.\u003c/p\u003e","description":"","filename":"Figure.2.png","url":"https://assets-eu.researchsquare.com/files/rs-3654833/v1/e18a8fe3a8382a03f88a439b.png"},{"id":49386796,"identity":"47753c86-3d81-47f6-b9aa-a1280ce925a9","added_by":"auto","created_at":"2024-01-09 20:00:42","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":62451,"visible":true,"origin":"","legend":"\u003cp\u003eThe incidence of DVT increased with the rising percentage of irradiated RBCs in total RBCs. A. The incidence of DVT increased from 22.4% to 43.8% with the rising percentage of irradiated RBCs in total transfused RBCs. B. The subgroup with a percentage of irradiated RBC transfused \u0026gt;0 and ≤30% had a higher total volume of RBC or plasma transfusion than the other three subgroups. C. The maximum storage days of nonirradiated RBCs was longer for the subgroup with irradiated RBC percentage \u0026gt;0 and ≤30% than the other three subgroups. D. The subgroup with a percentage of irradiated RBC transfused \u0026gt;0 and ≤30% had longer hospital days than the nonirradiation group. * represented \u003cem\u003eP\u0026lt;\u003c/em\u003e0.05, ** represented \u003cem\u003eP\u0026lt;\u003c/em\u003e0.01, *** represented \u003cem\u003eP\u0026lt;\u003c/em\u003e0.001. PCT: percentage.\u003c/p\u003e","description":"","filename":"Figure.3.png","url":"https://assets-eu.researchsquare.com/files/rs-3654833/v1/981889a02113a98c6904e201.png"},{"id":50960922,"identity":"cdc5d172-7195-4991-a486-f072ab8e3ddb","added_by":"auto","created_at":"2024-02-11 03:59:28","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":490153,"visible":true,"origin":"","legend":"","description":"","filename":"manuscriptv3.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3654833/v1_covered_160f283f-1a80-4534-87f0-4212b7f44d33.pdf"}],"financialInterests":"","formattedTitle":"Irradiated red blood cell transfusion is associated with an increased risk of deep vein thrombosis in trauma patients: a case control study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Irradiated red blood cells, Blood transfusion, Deep vein thrombosis, Trauma","lastPublishedDoi":"10.21203/rs.3.rs-3654833/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3654833/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground Gamma ray irradiation accelerates the release of red blood cell (RBC)-derived microparticles with procoagulant function, and further promotes the formation of microthrombosis. The use of irradiated RBCs in nontransplant patients is usually not prohibited, except in patients with renal dysfunction and hyperkalemia. At present, the possibility that irradiated RBC transfusion promotes the occurrence of deep vein thrombosis (DVT) remains unclear.\u003c/p\u003e\n\u003cp\u003eMethods This retrospective cohort study was conducted on 251 trauma patients enrolled between January 2021 and April 2023 at the Second Affiliated Hospital of Chongqing Medical University. The cohort included 147 patients who were only transfused with nonirradiated RBCs (nonirradiation group) and 104 patients who were transfused with irradiated RBCs with or without nonirradiated RBCs (irradiation group). Multivariate logistic regression was used to analyze the risk factors for DVT in this population.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults The incidence of DVT was higher in the irradiation group than in the nonirradiation group (38.5% vs 22.4%, P\u0026lt;0.01). After adjusting for inconsistent variables, the results showed that irradiated RBC transfusion was a significant risk factor for DVT (odds ratio =2.16, 95% confidence interval=1.24 to 3.76; P\u0026lt;0.01). The incidence of DVT increased from 22.4% to 43.8% with the rising percentage of irradiated RBCs in total transfused RBCs (P =0.0248). The median storage days and total units of irradiated RBCs were not associated with an increased risk of DVT (odds ratio \u0026lt;1, P\u0026gt;0.05). Further subgroup analysis showed that the total volume, median storage days, and maximum storage days of transfused RBCs were not associated with the occurrence of DVT in this cohort, regardless of whether the irradiation group was included (all, P\u0026gt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusions Irradiated RBC transfusion was associated with an increased risk of DVT in trauma patients in a percentage-dependent manner, and the total volume and longer storage duration of transfused RBCs were not associated with the incidence of DVT. The transfusion indications for irradiated RBCs should be strictly controlled to avoid unnecessary transfusion of irradiated RBCs to trauma patients.\u003c/p\u003e","manuscriptTitle":"Irradiated red blood cell transfusion is associated with an increased risk of deep vein thrombosis in trauma patients: a case control study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-09 19:52:37","doi":"10.21203/rs.3.rs-3654833/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9d5e1c0d-12b5-4654-a35d-0e2a7c03cfad","owner":[],"postedDate":"January 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-02-11T03:51:14+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-09 19:52:37","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3654833","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3654833","identity":"rs-3654833","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}