An analysis of blood transfusion practices in gunshot wound patients at a peripheral trauma-blood centre unit

Gunshot wounds (GSWs) pose a significant risk of haemorrhagic shock and early mortality. Effective transfusion support is critical for stabilizing these patients; however, data on transfusion patterns and demands in peripheral combat-support hospitals remain limited.

To assess the blood components transfusion practices in hospitalized GSW patients at a peripheral trauma care facility.

This retrospective cross-sectional study evaluated transfusion practices among hospitalized GSW patients managed at a peripheral trauma care centre situated within a counterinsurgency area from June 2020 to June 2022. Data were extracted from trauma care admissions and blood centre records to assess the frequency, timing, quantity, and types of blood products administered. The study also examined blood group demand and documented transfusion-related adverse events.

Of the 155 hospitalized patients with GSW, 51 (32.9%) required transfusions. Most demands (80%) occurred within the first 48 hours post-admission (56.9% within 24 hours and 23.5% between 24 and 48 hours). Whole blood (WB) was predominantly utilized (88 units), followed by FFP (80 units) and PRBC (76 units), with 9 units of RDP issued. Notably, 15 patients (29.4%) received combined WB and component therapy. The approximate ratio of PRBC:FFP was 1:1, indicating near-balanced plasma-to-RBC ratio. No transfusion-related adverse events were observed. A, B, and AB blood groups were issued almost equally, with lower group O unit utilization than the others.

This study highlights the substantial, time-sensitive transfusion demands for managing GSW patients within peripheral trauma systems operating in combat-related environments. The resurgence of WB, alongside balanced component therapy, underscores the importance of robust blood centre infrastructure, skilled personnel, and comprehensive inventory management to address unpredictable trauma demands.