Any Comorbidities in Adult Health as Predictors of Immediate Transfusion Reactions: Implications for Public Health Practice

Abstract

Blood transfusion is a central therapeutic intervention in adult care, particularly in high-complexity settings and among patients with noncommunicable chronic diseases (NCDs). However, immediate transfusion reactions (ITRs) represent significant adverse events, with clinical, care-related, and economic repercussions .Objective: To analyze the association between clinical conditions, comorbidities, and predictive factors for ITRs in adults, focusing on adult health and implications for public health practice.Methods: A retrospective, analytical cohort study conducted in a university hospital in southern Brazil, including 9,475 transfusions in adult patients in 2024. Sociodemographic and clinical variables, comorbidities, blood component characteristics, and donor data were analyzed. Poisson regression with robust variance was used to identify predictive factors.Results: The incidence of ITRs was 1.25%, with a predominance of allergic and febrile non-hemolytic reactions. Advanced age, diabetes mellitus, and the presence of multimorbidity were independently associated with a higher risk of ITRs. Routine use of premedication did not demonstrate a protective effect.Conclusion: Comorbidities and the adult clinical profile are important predictors of ITRs. The incorporation of predictive models and the strengthening of hemovigilance may enhance patient safety policies and support safer practices within the public health context.