Changes in red cell transfusion practice among adult trauma victims

被引:24
作者
Farion, KJ
McLellan, BA
Boulanger, BR
Szalai, JP
机构
[1] Univ Toronto, Sunnybrook Hlth Sci Ctr, Trauma Program, Toronto, ON, Canada
[2] Univ Toronto, Sunnybrook Hlth Sci Ctr, Dept Surg, Toronto, ON, Canada
来源
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE | 1998年 / 44卷 / 04期
关键词
blood transfusion; trauma; transfusion guidelines;
D O I
10.1097/00005373-199804000-00004
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Recent attention concerning the adverse outcomes of blood transfusion has resulted in decreased blood product usage for nonemergency care. We hypothesized that there has also been a decrease in blood product use in the management of seriously injured adults. Methods: A retrospective review of institutional database records was conducted at a regional trauma center for adults admitted during 1991, 1993, and 1995. Data was analyzed for trends in amount, type, and timing of blood product use. Results: A total of 1,738 patients were assessed, with 1,605 meeting inclusion. The three patient groups were similar, including injury severity coverall mean Injury Severity Score of 23.6), mechanism (88% blunt), and survival (87%). In 1991, 54% of the patients were transfused a total of 2,341 units of packed red blood cells (mean 4.67 units/pt treated) versus 42% of patients in 1995 (p < 0.0001) who received 2,018 packed red blood cells (mean 3.57 units/patient treated, p = 0.05). A significantly higher proportion of units was transfused in the first 24 hours of care in 1995 (64%) compared with 1991 (21%, p < 0.0001). A reduction in the use of universal donor type-O blood use was also found (1.21 vs. 0.65 units/patient transfused, p < 0.001). Despite similar admission hemoglobin concentrations (124.1 vs. 125.3, not significant), significant reductions were found in the average 24-hour (109.2 vs. 103.8, p < 0.001), lowest (96.5 vs 92.1, p < 0.01) and discharge (115.8 vs. 110.5, p < 0.001) concentrations. Conclusions: Between 1991 and 1995 there have been significant reductions in both the number of trauma patients receiving blood products and the total number of units transfused. These findings may reflect lower or abandoned hemoglobin transfusion triggers and increased awareness of complications related to transfusion.
引用
收藏
页码:583 / 587
页数:5
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