Transfusion quantities associated with 24-h mortality in trauma patients

Area of Science:

• Trauma care
• Transfusion medicine
• Critical care research

Background:

• Limited data exists on the correlation between transfusion volumes and trauma mortality.
• This study investigates the association between RBC and LTOWB units, and total blood product volume, with 24-hour mortality in trauma patients.

Purpose of the Study:

• To determine the association between the quantity of transfused red blood cells (RBC), low titer group O whole blood (LTOWB), and total blood product volume with 24-hour mortality in trauma patients.

Main Methods:

• Utilized Trauma Quality Improvement Program (TQIP) datasets from 2020-2022.
• Included patients aged ≥15 who received blood products.
• Employed receiver operating characteristic (ROC) analysis to assess the predictive association between transfusion quantity and 24-hour mortality.

Main Results:

• Analysis of 144,379 encounters revealed 22,467 deaths within 24 hours.
• A 90% probability of 24-hour mortality was associated with 56 RBC/LTOWB units (AUROC 0.673).
• A 90% probability of 24-hour mortality was associated with 36,000 mL of transfused products (AUROC 0.662).

Conclusions:

• Neither the total number of RBC/LTOWB units nor the total volume of blood products significantly predicted 24-hour mortality in the civilian trauma population.
• The predictive association between transfusion volume and mortality risk was poor.
• Further investigation into factors influencing trauma mortality post-transfusion is warranted.