Tags

Type your tag names separated by a space and hit enter

The impact of uncross-matched blood transfusion on the need for massive transfusion and mortality: analysis of 5,166 uncross-matched units.
J Trauma. 2008 Dec; 65(6):1222-6.JT

Abstract

BACKGROUND

The objective of this study was to analyze the outcomes associated with uncross-matched blood transfusion during trauma resuscitation. Our hypothesis was that uncross-matched blood transfusion is a predictor of the need for massive transfusion and mortality.

METHODS

All injured patients receiving packed red blood cell (PRBC) transfusion during a 6-year period ending December 2005 were identified from the blood bank database at a level I trauma center. Uncross-matched red blood cell (URBC) and cross-matched red blood cells, plasma and platelet utilization, and injury demographics were abstracted for each patient.

RESULTS

Of 25,599 trauma patients, 4,241 (16.6%) patients received 29,375 units of PRBC and 1,236 (29.1%) of the transfused patients received 5,166 units of URBC during their resuscitation. Patients requiring URBC had a higher mortality (39.6% vs. 11.9%, p < 0.001) and were more likely to require massive (> or = 10 PRBC during 12 hours) transfusion (29.3% vs. 1.8%, p < 0.001). There was a stepwise increase in mortality with increasing URBC transfusion. After adjusting for age, gender, mechanism, hypotension at admission, emergency department intubation, initial hemoglobin, Glasgow Coma Scale, Abbreviated Injury Scale, Injury Severity Score, and amount of blood products received; URBC remained an independent predictor of mortality (adjusted odds ratio 2.15; 95% confidence interval 1.58-2.94; p < 0.001) and massive transfusion (adjusted odds ratio, 11.87; 95% confidence interval, 8.43-16.7; p < 0.001). Patients receiving URBC also utilized more blood components (11.9 +/- 12.7 vs. 4.9 +/- 5.8 units of PRBC, p < 0.001; 5.1 +/- 8.9 vs. 2.0 +/- 4.8 units of plasma, p < 0.001; and 1.1 +/- 2.5 vs. 0.4 +/- 1.6 units of platelets, p < 0.001).

CONCLUSION

The requirement for uncross-matched blood during the acute resuscitation of trauma patients is an independent predictor of mortality and the need for massive transfusion. A URBC request during resuscitation should be considered by the blood bank as a potential trigger to prepare for massive transfusion.

Authors+Show Affiliations

Division of Trauma Surgery and Surgical Critical Care, University of Southern California, Los Angeles, California 90033, USA. kinaba@surgery.usc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19077605

Citation

Inaba, Kenji, et al. "The Impact of Uncross-matched Blood Transfusion On the Need for Massive Transfusion and Mortality: Analysis of 5,166 Uncross-matched Units." The Journal of Trauma, vol. 65, no. 6, 2008, pp. 1222-6.
Inaba K, Teixeira PG, Shulman I, et al. The impact of uncross-matched blood transfusion on the need for massive transfusion and mortality: analysis of 5,166 uncross-matched units. J Trauma. 2008;65(6):1222-6.
Inaba, K., Teixeira, P. G., Shulman, I., Nelson, J., Lee, J., Salim, A., Brown, C., Demetriades, D., & Rhee, P. (2008). The impact of uncross-matched blood transfusion on the need for massive transfusion and mortality: analysis of 5,166 uncross-matched units. The Journal of Trauma, 65(6), 1222-6. https://doi.org/10.1097/TA.0b013e31818e8ff3
Inaba K, et al. The Impact of Uncross-matched Blood Transfusion On the Need for Massive Transfusion and Mortality: Analysis of 5,166 Uncross-matched Units. J Trauma. 2008;65(6):1222-6. PubMed PMID: 19077605.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of uncross-matched blood transfusion on the need for massive transfusion and mortality: analysis of 5,166 uncross-matched units. AU - Inaba,Kenji, AU - Teixeira,Pedro G R, AU - Shulman,Ira, AU - Nelson,Janice, AU - Lee,John, AU - Salim,A, AU - Brown,Carlos, AU - Demetriades,Demetrios, AU - Rhee,Peter, PY - 2008/12/17/entrez PY - 2008/12/17/pubmed PY - 2009/1/17/medline SP - 1222 EP - 6 JF - The Journal of trauma JO - J Trauma VL - 65 IS - 6 N2 - BACKGROUND: The objective of this study was to analyze the outcomes associated with uncross-matched blood transfusion during trauma resuscitation. Our hypothesis was that uncross-matched blood transfusion is a predictor of the need for massive transfusion and mortality. METHODS: All injured patients receiving packed red blood cell (PRBC) transfusion during a 6-year period ending December 2005 were identified from the blood bank database at a level I trauma center. Uncross-matched red blood cell (URBC) and cross-matched red blood cells, plasma and platelet utilization, and injury demographics were abstracted for each patient. RESULTS: Of 25,599 trauma patients, 4,241 (16.6%) patients received 29,375 units of PRBC and 1,236 (29.1%) of the transfused patients received 5,166 units of URBC during their resuscitation. Patients requiring URBC had a higher mortality (39.6% vs. 11.9%, p < 0.001) and were more likely to require massive (> or = 10 PRBC during 12 hours) transfusion (29.3% vs. 1.8%, p < 0.001). There was a stepwise increase in mortality with increasing URBC transfusion. After adjusting for age, gender, mechanism, hypotension at admission, emergency department intubation, initial hemoglobin, Glasgow Coma Scale, Abbreviated Injury Scale, Injury Severity Score, and amount of blood products received; URBC remained an independent predictor of mortality (adjusted odds ratio 2.15; 95% confidence interval 1.58-2.94; p < 0.001) and massive transfusion (adjusted odds ratio, 11.87; 95% confidence interval, 8.43-16.7; p < 0.001). Patients receiving URBC also utilized more blood components (11.9 +/- 12.7 vs. 4.9 +/- 5.8 units of PRBC, p < 0.001; 5.1 +/- 8.9 vs. 2.0 +/- 4.8 units of plasma, p < 0.001; and 1.1 +/- 2.5 vs. 0.4 +/- 1.6 units of platelets, p < 0.001). CONCLUSION: The requirement for uncross-matched blood during the acute resuscitation of trauma patients is an independent predictor of mortality and the need for massive transfusion. A URBC request during resuscitation should be considered by the blood bank as a potential trigger to prepare for massive transfusion. SN - 1529-8809 UR - https://www.unboundmedicine.com/medline/citation/19077605/The_impact_of_uncross_matched_blood_transfusion_on_the_need_for_massive_transfusion_and_mortality:_analysis_of_5166_uncross_matched_units_ L2 - https://doi.org/10.1097/TA.0b013e31818e8ff3 DB - PRIME DP - Unbound Medicine ER -