Document Detail


The association between the transfusion of older blood and outcomes after trauma.
MedLine Citation:
PMID:  20823694     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Allogeneic packed red blood cells (PRBCs) suppress immunity and influence outcomes. The influence of blood on the risk of infection and death may be related to the duration of storage. We sought to determine whether blood storage duration was associated with infection or death in a large cohort of injury victims. We reviewed a cohort of trauma patients transfused at least 1 U of PRBCs within 24 h of admission to a level 1 trauma center. The outcomes of interest were complicated sepsis and mortality. We compared the amount of older blood (>14 days storage) given to patients who did or did not develop the outcomes of interest using univariate and multivariate methods. A total of 820 patients were included. Patients who died (n = 117) received more units of older blood than those who lived (5 U [inter quartile range {IQR}, 2-9] vs. 3 U [IQR, 2-6]; P < 0.001). Patients with complicated sepsis (n = 244) received a greater volume of older blood than those without complicated sepsis (6 U [IQR, 2-10] vs. 3 U [IQR, 1-5]; P < 0.001). After adjusting for clinical factors, including the total amount of blood transfused, patients receiving greater than or equal to 7 U of older blood had a higher risk of complicated sepsis than patients receiving 1 or fewer units (odds ratio, 1.9; P = 0.03). The risk for complicated sepsis and death in trauma victims who are transfused blood is high. The amount of older blood transfused is associated with complicated sepsis. Although the best strategy to minimize the effects of allogeneic blood is to avoid unnecessary transfusions, it may be particularly important to avoid transfusing multiple units of older blood.
Authors:
Monique Hassan; Tam N Pham; Joseph Cuschieri; Keir J Warner; Theresa Nester; Ronald V Maier; Sherene Shalhub; Grant E O'Keefe
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  35     ISSN:  1540-0514     ISO Abbreviation:  Shock     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-16     Completed Date:  2011-04-15     Revised Date:  2012-01-04    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3-8     Citation Subset:  IM    
Affiliation:
Harborview Medical Center, University of Washington, Seattle, WA 98104-2499, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Preservation / adverse effects
Erythrocyte Transfusion / adverse effects*,  mortality*
Humans
Multivariate Analysis
Retrospective Studies
Sepsis / etiology
Time Factors
Trauma Centers / statistics & numerical data
Treatment Outcome
Wounds and Injuries / mortality,  therapy*
Grant Support
ID/Acronym/Agency:
1R01GM066946/GM/NIGMS NIH HHS; 5P50GM021681-370013/GM/NIGMS NIH HHS; R01 GM066946-04/GM/NIGMS NIH HHS; T32 GM007037-34/GM/NIGMS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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