Document Detail


Blood utilization in patients with burn injury and association with clinical outcomes (CME).
MedLine Citation:
PMID:  23278449     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Uncontrolled bleeding is an important cause of increased transfusion in burn victims; however, description of blood utilization patterns in the burn population is lacking.
STUDY DESIGN AND METHODS: We conducted a single-institution, retrospective cohort study to measure blood utilization in 89 consecutive burn patients with 15% to 65% total body surface area (TBSA) burn within 60 days of injury. We also evaluated the relationship of blood product utilization with clinical variables including anticoagulant usage and mortality.
RESULTS: We determined that: 1) the predictors for increased red blood cells (RBCs) and plasma transfusions were high TBSA burn and the use of argatroban anticoagulation (for suspected heparin-induced thrombocytopenia [HIT]); 2) TBSA burn and patient age were independent predictors of mortality, but not RBC or plasma transfusion; and 3) the incidence of symptomatic venous thromboembolic events is not uncommon (11.2%), although HIT is rare (1.1%).
CONCLUSION: Despite concerns about adverse correlation between increased number of transfusions and mortality in other clinical settings, we did not find this association in our study. However, we demonstrated that the type and intensity of anticoagulation carries substantial risk for increased RBC as well as plasma usage.
Authors:
Rommel P Lu; Feng-Chang Lin; Shiara M Ortiz-Pujols; Sasha D Adams; Herbert C Whinna; Bruce A Cairns; Nigel S Key
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-12-24
Journal Detail:
Title:  Transfusion     Volume:  53     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-08     Completed Date:  2013-12-04     Revised Date:  2014-10-14    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2212-21; quiz 2211     Citation Subset:  IM    
Copyright Information:
© 2012 American Association of Blood Banks.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anticoagulants / therapeutic use
Blood Transfusion / utilization*
Burns / mortality,  therapy*
Cohort Studies
Female
Humans
Linear Models
Logistic Models
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Venous Thromboembolism / epidemiology
Grant Support
ID/Acronym/Agency:
5UL1RR025747/RR/NCRR NIH HHS; T32 HL007149/HL/NHLBI NIH HHS; T32HL007149/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Anticoagulants
Comments/Corrections

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