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Outcome analysis of blood product transfusion in trauma patients: a prospective, risk-adjusted study.
World J Surg. 2008 Oct; 32(10):2185-9.WJ

Abstract

BACKGROUND

Studies have confirmed adverse outcome associated with transfusion of packed red blood cells (PRBCs) in trauma; however, little data are available regarding other blood product transfusion, such as fresh frozen plasma (FFP) and platelets. The objective of this study was to examine risk-adjusted outcome in trauma with stratification by blood product type.

METHODS

Prospective data were collected daily for 1,172 consecutive trauma patients admitted to the intensive care unit (ICU) during a 2-year period, including transfusion rates of blood products (PRBCs, FFP, platelets). Outcome assessment included infection rate, ventilator days (Vdays), ICU and hospital length of stay (LOS), and mortality.

RESULTS

Blood products were transfused in 786 (67%) patients. The study cohort had a mean age of 43 +/- 21 years and Injury Severity Score (ISS) of 24 +/- 13. Although the majority of patients were men, women were more likely to be transfused (p < 0.001). Mean transfusion rates of PRBCs (5.5 +/- 9.6 U), FFP (5.4 +/- 11.4), and platelets (3.7 +/- 11.1) were high. Univariate analysis identified that blood product transfusion (any type) was associated with a significantly greater infection rate (34% vs. 9.4%; p < 0.001), hospital LOS (18.6 vs. 9 days; p < 0.001), ICU LOS (13.7 vs. 7.4 days; p < 0.001), Vdays (12.9 vs. 6.3 days; p < 0.001), and mortality (19% vs. 8.3%; p < 0.001). Multivariate analysis (risk-adjusted for severity of injury by ISS, age, sex, and race, and stratified by blood product type) confirmed that risk of infection increased by 5%, and hospital LOS, ICU LOS, and Vdays increased by 0.64, 0.42, and 0.47 days, respectively, for every unit of PRBCs given. Risk of death increased by 3.5% for every unit of FFP transfused.

CONCLUSION

There is a dose-dependent correlation between blood product transfusion and adverse outcome (increased mortality and infection) in trauma patients.

Authors+Show Affiliations

R. Adams Cowley Shock Trauma Center Programs in Trauma, 22 South Greene Street, Baltimore, MD 21201, USA. gbochicchio@umm.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18575931

Citation

Bochicchio, Grant V., et al. "Outcome Analysis of Blood Product Transfusion in Trauma Patients: a Prospective, Risk-adjusted Study." World Journal of Surgery, vol. 32, no. 10, 2008, pp. 2185-9.
Bochicchio GV, Napolitano L, Joshi M, et al. Outcome analysis of blood product transfusion in trauma patients: a prospective, risk-adjusted study. World J Surg. 2008;32(10):2185-9.
Bochicchio, G. V., Napolitano, L., Joshi, M., Bochicchio, K., Meyer, W., & Scalea, T. M. (2008). Outcome analysis of blood product transfusion in trauma patients: a prospective, risk-adjusted study. World Journal of Surgery, 32(10), 2185-9. https://doi.org/10.1007/s00268-008-9655-0
Bochicchio GV, et al. Outcome Analysis of Blood Product Transfusion in Trauma Patients: a Prospective, Risk-adjusted Study. World J Surg. 2008;32(10):2185-9. PubMed PMID: 18575931.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome analysis of blood product transfusion in trauma patients: a prospective, risk-adjusted study. AU - Bochicchio,Grant V, AU - Napolitano,Lena, AU - Joshi,Manjari, AU - Bochicchio,Kelly, AU - Meyer,Walter, AU - Scalea,Thomas M, PY - 2008/6/26/pubmed PY - 2009/8/6/medline PY - 2008/6/26/entrez SP - 2185 EP - 9 JF - World journal of surgery JO - World J Surg VL - 32 IS - 10 N2 - BACKGROUND: Studies have confirmed adverse outcome associated with transfusion of packed red blood cells (PRBCs) in trauma; however, little data are available regarding other blood product transfusion, such as fresh frozen plasma (FFP) and platelets. The objective of this study was to examine risk-adjusted outcome in trauma with stratification by blood product type. METHODS: Prospective data were collected daily for 1,172 consecutive trauma patients admitted to the intensive care unit (ICU) during a 2-year period, including transfusion rates of blood products (PRBCs, FFP, platelets). Outcome assessment included infection rate, ventilator days (Vdays), ICU and hospital length of stay (LOS), and mortality. RESULTS: Blood products were transfused in 786 (67%) patients. The study cohort had a mean age of 43 +/- 21 years and Injury Severity Score (ISS) of 24 +/- 13. Although the majority of patients were men, women were more likely to be transfused (p < 0.001). Mean transfusion rates of PRBCs (5.5 +/- 9.6 U), FFP (5.4 +/- 11.4), and platelets (3.7 +/- 11.1) were high. Univariate analysis identified that blood product transfusion (any type) was associated with a significantly greater infection rate (34% vs. 9.4%; p < 0.001), hospital LOS (18.6 vs. 9 days; p < 0.001), ICU LOS (13.7 vs. 7.4 days; p < 0.001), Vdays (12.9 vs. 6.3 days; p < 0.001), and mortality (19% vs. 8.3%; p < 0.001). Multivariate analysis (risk-adjusted for severity of injury by ISS, age, sex, and race, and stratified by blood product type) confirmed that risk of infection increased by 5%, and hospital LOS, ICU LOS, and Vdays increased by 0.64, 0.42, and 0.47 days, respectively, for every unit of PRBCs given. Risk of death increased by 3.5% for every unit of FFP transfused. CONCLUSION: There is a dose-dependent correlation between blood product transfusion and adverse outcome (increased mortality and infection) in trauma patients. SN - 0364-2313 UR - https://www.unboundmedicine.com/medline/citation/18575931/Outcome_analysis_of_blood_product_transfusion_in_trauma_patients:_a_prospective_risk_adjusted_study_ L2 - https://dx.doi.org/10.1007/s00268-008-9655-0 DB - PRIME DP - Unbound Medicine ER -