Transfusion of ABO non-identical platelets increases the severity of trauma patients at ICU admission
ABSTRACT Background: Transfusion of ABO-compatible non-identical platelets (PTLs), fresh plasma (FP) and red blood cells (RBCs) has been associated with increased morbidity and mortality of recipients. Trauma victims are frequently exposed to ABO non-identical products, given the need for emergency transfusions. Our goal was to evaluate the impact of the transfusion of ABO non-identical blood products on the severity and all-cause 30-day mortality of trauma patients. Methods: This was a retrospective single-center cohort, which included trauma patients who received emergency transfusions in the first 24 h of hospitalization. Patients were divided in two groups according to the use of <3 or ≥3 ABO non-identical blood products. The patient severity, measured by the Acute Physiology and Chronic Health Evaluation (APACHEII) score at ICU admission, and the 30-day mortality were compared between groups. Results: Two hundred and sixteen trauma patients were enrolled. Of these, 21.3% received ≥3 ABO non-identical blood products (RBCs, PLTs and FP or cryoprecipitate). The transfusion of ≥3 ABO non-identical blood products in the first 24 h of hospitalization was independently associated with a higher APACHEII score at ICU admission (OR = 3.28 and CI95% = 1.48–7.16). Transfusion of at least one unit of ABO non-identical PTLs was also associated with severity (OR = 10.89 and CI95% = 3.38–38.49). Transfusion of ABO non-identical blood products was not associated with a higher 30-day mortality in the studied cohort. Conclusion: The transfusion of ABO non-identical blood products and, especially, of ABO non-identical PLTs may be associated with the greater severity of trauma patients at ICU admission. The transfusion of ABO non-identical blood products in the trauma setting is not without risks.
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Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH)
2021
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oai:scielo:S2531-137920210003002872021-10-14Transfusion of ABO non-identical platelets increases the severity of trauma patients at ICU admissionSilva,Adriana Lucia de OliveiraBassolli,LucasFerreira,PedroUtiyama,EdivaldoDezan,Marcia ReginaCosta-Neto,AbelConrado,Marina C.A.VOliveira,Valeria BritoBonifácio,Silvia LeãoFernandes,Frederico Leon ArrabalRocha,VandersonMendrone-Júnior,AlfredoDinardo,Carla Luana Abo Non identical Transfusion Trauma Platelets ABSTRACT Background: Transfusion of ABO-compatible non-identical platelets (PTLs), fresh plasma (FP) and red blood cells (RBCs) has been associated with increased morbidity and mortality of recipients. Trauma victims are frequently exposed to ABO non-identical products, given the need for emergency transfusions. Our goal was to evaluate the impact of the transfusion of ABO non-identical blood products on the severity and all-cause 30-day mortality of trauma patients. Methods: This was a retrospective single-center cohort, which included trauma patients who received emergency transfusions in the first 24 h of hospitalization. Patients were divided in two groups according to the use of <3 or ≥3 ABO non-identical blood products. The patient severity, measured by the Acute Physiology and Chronic Health Evaluation (APACHEII) score at ICU admission, and the 30-day mortality were compared between groups. Results: Two hundred and sixteen trauma patients were enrolled. Of these, 21.3% received ≥3 ABO non-identical blood products (RBCs, PLTs and FP or cryoprecipitate). The transfusion of ≥3 ABO non-identical blood products in the first 24 h of hospitalization was independently associated with a higher APACHEII score at ICU admission (OR = 3.28 and CI95% = 1.48–7.16). Transfusion of at least one unit of ABO non-identical PTLs was also associated with severity (OR = 10.89 and CI95% = 3.38–38.49). Transfusion of ABO non-identical blood products was not associated with a higher 30-day mortality in the studied cohort. Conclusion: The transfusion of ABO non-identical blood products and, especially, of ABO non-identical PLTs may be associated with the greater severity of trauma patients at ICU admission. The transfusion of ABO non-identical blood products in the trauma setting is not without risks.info:eu-repo/semantics/openAccessAssociação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH)Hematology, Transfusion and Cell Therapy v.43 n.3 20212021-09-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2531-13792021000300287en10.1016/j.htct.2020.06.011 |
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Silva,Adriana Lucia de Oliveira Bassolli,Lucas Ferreira,Pedro Utiyama,Edivaldo Dezan,Marcia Regina Costa-Neto,Abel Conrado,Marina C.A.V Oliveira,Valeria Brito Bonifácio,Silvia Leão Fernandes,Frederico Leon Arrabal Rocha,Vanderson Mendrone-Júnior,Alfredo Dinardo,Carla Luana |
| spellingShingle |
Silva,Adriana Lucia de Oliveira Bassolli,Lucas Ferreira,Pedro Utiyama,Edivaldo Dezan,Marcia Regina Costa-Neto,Abel Conrado,Marina C.A.V Oliveira,Valeria Brito Bonifácio,Silvia Leão Fernandes,Frederico Leon Arrabal Rocha,Vanderson Mendrone-Júnior,Alfredo Dinardo,Carla Luana Transfusion of ABO non-identical platelets increases the severity of trauma patients at ICU admission |
| author_facet |
Silva,Adriana Lucia de Oliveira Bassolli,Lucas Ferreira,Pedro Utiyama,Edivaldo Dezan,Marcia Regina Costa-Neto,Abel Conrado,Marina C.A.V Oliveira,Valeria Brito Bonifácio,Silvia Leão Fernandes,Frederico Leon Arrabal Rocha,Vanderson Mendrone-Júnior,Alfredo Dinardo,Carla Luana |
| author_sort |
Silva,Adriana Lucia de Oliveira |
| title |
Transfusion of ABO non-identical platelets increases the severity of trauma patients at ICU admission |
| title_short |
Transfusion of ABO non-identical platelets increases the severity of trauma patients at ICU admission |
| title_full |
Transfusion of ABO non-identical platelets increases the severity of trauma patients at ICU admission |
| title_fullStr |
Transfusion of ABO non-identical platelets increases the severity of trauma patients at ICU admission |
| title_full_unstemmed |
Transfusion of ABO non-identical platelets increases the severity of trauma patients at ICU admission |
| title_sort |
transfusion of abo non-identical platelets increases the severity of trauma patients at icu admission |
| description |
ABSTRACT Background: Transfusion of ABO-compatible non-identical platelets (PTLs), fresh plasma (FP) and red blood cells (RBCs) has been associated with increased morbidity and mortality of recipients. Trauma victims are frequently exposed to ABO non-identical products, given the need for emergency transfusions. Our goal was to evaluate the impact of the transfusion of ABO non-identical blood products on the severity and all-cause 30-day mortality of trauma patients. Methods: This was a retrospective single-center cohort, which included trauma patients who received emergency transfusions in the first 24 h of hospitalization. Patients were divided in two groups according to the use of <3 or ≥3 ABO non-identical blood products. The patient severity, measured by the Acute Physiology and Chronic Health Evaluation (APACHEII) score at ICU admission, and the 30-day mortality were compared between groups. Results: Two hundred and sixteen trauma patients were enrolled. Of these, 21.3% received ≥3 ABO non-identical blood products (RBCs, PLTs and FP or cryoprecipitate). The transfusion of ≥3 ABO non-identical blood products in the first 24 h of hospitalization was independently associated with a higher APACHEII score at ICU admission (OR = 3.28 and CI95% = 1.48–7.16). Transfusion of at least one unit of ABO non-identical PTLs was also associated with severity (OR = 10.89 and CI95% = 3.38–38.49). Transfusion of ABO non-identical blood products was not associated with a higher 30-day mortality in the studied cohort. Conclusion: The transfusion of ABO non-identical blood products and, especially, of ABO non-identical PLTs may be associated with the greater severity of trauma patients at ICU admission. The transfusion of ABO non-identical blood products in the trauma setting is not without risks. |
| publisher |
Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH) |
| publishDate |
2021 |
| url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2531-13792021000300287 |
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