Analysis of Transfusion Volumes in the Elderly Trauma Population

Manrique Alberto Guerrero, Monica Sridhar, Stephanie Yee, Jacob Miller, Jafar Haghshenas, Jamshed Zuberi, Robert Madlinger

Abstract


Background: Blood transfusion and old age have been independently associated with worse outcomes and higher mortality in the trauma population. Determining specific volumes and ratios of blood products for the elderly population, a special population with varied hemodynamic responses to traumatic injury, is a challenge. This study was aimed at delineating the relationship between specific transfusion volumes and mortality with an ultimate goal of finding an optimal threshold where risk outweighs benefit.

Methods: A retrospective study of data from patients aged 65 and older at a level II urban trauma center was conducted. All patients who were included in the study presented to the emergency department between January 2013 and January 2016 and received a blood product transfusion (n = 93). The primary outcome was defined as mortality 24 h after transfusion, while the secondary outcome measured was length of hospital stay. Optimal cut-off points were estimated using Youden J coefficients, and Cox proportional hazard ratio (HR) was performed to calculate mortality risk.

Results: Patients receiving less than 5 units of blood product had a shorter length of stay (5.19 days) and decreased risk of mortality (HR = 2.48, P = 0.01). Patients receiving ≥ 5 units of a blood product had a statistically significant increase in risk of mortality (HR = 6.207, P < 0.001) and length of hospital stay (12.47 days), regardless of injury severity score. The administration of fresh frozen plasma was also an independent predictor of mortality. Patients who received a plasma transfusion had an increased risk of mortality (HR = 3.25, P < 0.001).

Conclusion: In this study, a threshold point of greater than 5 units of blood products has been associated with increased mortality and length of hospital stay. A more restrictive transfusion strategy has potential for improved outcomes.




J Curr Surg. 2019;9(4):45-50
doi: https://doi.org/10.14740/jcs392


Keywords


Retrospective study; Transfusion volume; Elderly trauma; Threshold volume; Restrictive transfusion strategy; Liberal transfusion strategy; Blood products

Full Text: HTML PDF
 

Browse  Journals  

     

Journal of clinical Medicine Research

Journal of Endocrinology and Metabolism

Journal of Clinical Gynecology and Obstetrics

World Journal of Oncology

Gastroenterology Research

Journal of Hematology

Journal of Medical Cases

Journal of Current Surgery

Clinical Infection and Immunity

Cardiology Research

World Journal of Nephrology and Urology

Cellular and Molecular Medicine Research

Journal of Neurology Research

International Journal of Clinical Pediatrics

 

 

 

 

 

Journal of Current Surgery, quarterly, ISSN 1927-1298 (print), 1927-1301 (online), published by Elmer Press Inc.            
The content of this site is intended for health care professionals.
This is an open-access journal distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons Attribution license (Attribution-NonCommercial 4.0 International CC-BY-NC 4.0)


This journal follows the International Committee of Medical Journal Editors (ICMJE) recommendations for manuscripts submitted to biomedical journals,
the Committee on Publication Ethics (COPE) guidelines, and the Principles of Transparency and Best Practice in Scholarly Publishing.

website: www.currentsurgery.org   editorial contact: editor@currentsurgery.org
Address: 9225 Leslie Street, Suite 201, Richmond Hill, Ontario, L4B 3H6, Canada

© Elmer Press Inc. All Rights Reserved.