Influence of Blood Transfusion on the Clinical Course and Immediate Outcome of Trauma Patients: Retrospective Study in a Tertiary Trauma Care Centre in Northern India

Authors

  • Arulselvi Subramanian Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, AIIMS, New Delhi, India
  • Venencia Albert Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, AIIMS, New Delhi, India
  • Priyanka Aggarwal Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, AIIMS, New Delhi, India
  • Daminii Singh Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, AIIMS, New Delhi, India
  • Ravindra Mohan Pandey Department of Biostatistics, AIIMS, New Delhi, India

DOI:

https://doi.org/10.15379/2408-9877.2016.03.02.02

Keywords:

RBC transfusion, Trauma, Organ failure, Infection, Mortality

Abstract

Background: Red blood cell transfusion is a prominent faction of the standard protocol for management of trauma patients. Clinical research over the past two decades has linked RBC transfusion with increased odds of morbidity and mortality. We conducted a study to assess influence of transfusion on survival and the clinical course of trauma patients in a level I trauma care center.

Methodology: Retrospective review of the blood bank registry was conducted (Jan-June 2012). 100 acutely injured trauma patients who received blood transfusion were selected and categorized based on the number of units transfused; group I (1-5 units) n= 40; group II (6-9 units) n=40 & group III (>10 units) n= 20. Study control were trauma patients who did not receive transfusion group IV (n= 40). The clinical course of the patients was followed via computerized patient record system maintained by our institution. Analysis was done to compare outcome (in hospital mortality, organ failure, infections, length of stay) between the study and control groups, also between groups based on units transfused.

Results: Severity of injury was significantly higher in patients who received transfusion than those who did not (p< 0.001). Transfusion was associated with high rate of infection (62%), organ failures (43%) and mortality (39%). Number of units transfused also correlated with injury severity (p< 0.001). Incidence of renal failure (20%), liver failure (35%) was high in group II. Also 50% developed sepsis in group II compared to 13.6 % in group I, and 31.8 % in group III. (p< 0.001). Highest mortality rate was observed in group II (67.5%), followed by 60% in group III and lowest in group IV 2.5% (p< 0.001).

Conclusion: We observed a surrogate relationship between severity of injury and transfusion requirements. Transfusion-related adversities may be more reflective of the confounding effect of severity of injury than RBC transfusion. Therefore evaluating the risks and benefits of blood transfusion in trauma management is recommended.

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Published

2016-07-28

Issue

Vol. 3 No. 2 (2016)

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