scholarly journals Association between the plasma-to-red blood cell ratio and survival in geriatric and non-geriatric trauma patients undergoing massive transfusion: a retrospective cohort study

2022 ◽  
Vol 10 (1) ◽  
Author(s):  
Mitsuaki Kojima ◽  
Akira Endo ◽  
Atsushi Shiraishi ◽  
Tomohisa Shoko ◽  
Yasuhiro Otomo ◽  
...  
Keyword(s):  
Adverse Events ◽  
Blood Cell ◽  
Hospital Mortality ◽  
Red Blood Cell ◽  
Odds Ratio ◽  
Additive Model ◽  
Geriatric Trauma ◽  
Trauma Patients ◽  
Entire Cohort ◽  
Transfusion Ratio

Abstract Background The benefits of a high plasma-to-red blood cell (RBC) ratio on the survival of injured patients who receive massive transfusions remain unclear, especially in older patients. We aimed to investigate the interaction of age with the plasma-to-RBC ratio and clinical outcomes of trauma patients. Methods In this retrospective study conducted from 2013 to 2016, trauma patients who received massive transfusions were included. Using a generalized additive model (GAM),we assessed how the plasma-to-RBC ratio and age affected the in-hospital mortality rates. The association of the plasma-to-RBC ratio [low (< 0.5), medium (0.5–1.0), and high (≥ 1.0)] with in-hospital mortality and the incidence of adverse events were assessed for the overall cohort and for patients stratified into non-geriatric (16–64 years) and geriatric (≥ 65 years) groups using logistic regression analyses. Results In total, 13,894 patients were included. The GAM plot of the plasma-to-RBC ratio for in-hospital mortality demonstrated a downward convex unimodal curve for the entire cohort. The low-transfusion ratio group was associated with increased odds of in-hospital mortality in the non-geriatric cohort [odds ratio 1.38, 95% confidence interval (CI) 1.22–1.56]; no association was observed in the geriatric group (odds ratio 0.84, 95% CI 0.62–1.12). An increase in the transfusion ratio was associated with a higher incidence of adverse events in the non-geriatric and geriatric groups. Conclusion The association of the non-geriatric age category and plasma-to-RBC ratio for in-hospital mortality was clearly demonstrated. However, the relationship between the plasma-to-RBC ratio with mortality among geriatric patients remains inconclusive.

Survival of trauma patients after massive red blood cell transfusion using a high or low red blood cell to plasma transfusion ratio*

2011 ◽  
Vol 39 (6) ◽  
pp. 1507-1513 ◽  
Author(s):  
Anita Rajasekhar ◽  
Rob Gowing ◽  
Ryan Zarychanski ◽  
Donald M. Arnold ◽  
Wendy Lim ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Red Blood Cell Transfusion ◽  
Trauma Patients ◽  
Plasma Transfusion ◽  
Transfusion Ratio

scholarly journals Red blood cell distribution width and outcome in trauma patients

2021 ◽  
Vol 121 (2) ◽  
pp. 221-228
Author(s):  
McKenzie Brown ◽  
Sean Nassoiy ◽  
Timothy Plackett ◽  
Fred Luchette ◽  
Joseph Posluszny
Keyword(s):  
Blood Cell ◽  
Hospital Mortality ◽  
Red Blood Cell ◽  
Trauma Patients ◽  
Cell Distribution ◽  
Distribution Width ◽  
Discharge Disposition ◽  
Trauma Service ◽  
Red Blood Cell Distribution

Abstract Context Red blood cell distribution width (RDW) has been used to predict mortality during infection and inflammatory diseases. It also been purported to be predictive of mortality following traumatic injury. Objective To identify the role of RDW in predicting mortality in trauma patients. We also sought to identify the role of RDW in predicting the development of sepsis in trauma patients. Methods A retrospective observational study was performed of the medical records for all adult trauma patients admitted to Loyola University Medical Center from 2007 to 2014. Patients admitted for fewer than four days were excluded. Admission, peak, and change from admission to peak (Δ) RDW were recorded to determine the relationship with in-hospital mortality. Patient age, development of sepsis during the hospitalization, admission to the intensive care unit (ICU), and discharge disposition were also examined. Results A total of 9,845 patients were admitted to the trauma service between 2007 and 2014, and a total of 2,512 (25.5%) patients fit the inclusion criteria and had both admission and peak values available. One-hundred twenty (4.6%) died while in the hospital. RDW values for all patients were (mean [standard deviation, SD]): admission 14.09 (1.88), peak 15.09 (2.34), and Δ RDW 1.00 (1.44). Admission, peak, and Δ RDW were not significant predictors of mortality (all p>0.50; hazard ratio [HR], 1.01–1.03). However, trauma patients who eventually developed sepsis had significantly higher RDW values (admission RDW: 14.27 (2.02) sepsis vs. 13.98 (1.73) no sepsis, p<0.001; peak RDW: 15.95 (2.55) vs. 14.51 (1.97), p<0.001; Δ RDW: 1.68 (1.77) vs. 0.53 (0.91), p<0.001). Conclusion Admission, peak, and Δ RDW were not associated with in-hospital mortality in adult trauma patients with a length of stay (LOS) ≥four days. However, the development of sepsis in trauma patients is closely linked to increased RDW values and in-hospital mortality.

Donor white blood cell survival and cytokine profiles following red blood cell transfusion in Australian major trauma patients

2018 ◽  
Vol 103 ◽  
pp. 229-234 ◽  
Author(s):  
Rena Hirani ◽  
Melinda M. Dean ◽  
Zsolt J. Balogh ◽  
Natalie J. Lott ◽  
Julie Seggie ◽  
...  
Keyword(s):  
Blood Cell ◽  
Cell Survival ◽  
White Blood Cell ◽  
Red Blood Cell ◽  
Major Trauma ◽  
Red Blood Cell Transfusion ◽  
Trauma Patients ◽  
Cytokine Profiles

scholarly journals Red blood cell age and potentiation of transfusion-related pathology in trauma patients

Transfusion ◽  
2011 ◽  
Vol 51 (4) ◽  
pp. 867-873 ◽  
Author(s):  
Jordan A. Weinberg ◽  
Scott R. Barnum ◽  
Rakesh P. Patel
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Trauma Patients ◽  
Cell Age

Impact of minimal invasive extracorporeal circulation on the need of red blood cell transfusion

Perfusion ◽  
2019 ◽  
Vol 34 (7) ◽  
pp. 605-612 ◽  
Author(s):  
Sten Ellam ◽  
Otto Pitkänen ◽  
Pasi Lahtinen ◽  
Tadeusz Musialowicz ◽  
Mikko Hippeläinen ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Extracorporeal Circulation ◽  
Odds Ratio ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Minimal Invasive ◽  
Red Blood Cell Transfusion ◽  
Red Blood Cell Transfusions ◽  
Hemoglobin Drop

Objective: Minimal invasive extracorporeal circulation may decrease the need of packed red blood cell transfusions and reduce hemodilution during cardiopulmonary bypass. However, more data are needed on the effects of minimal invasive extracorporeal circulation in more complex cardiac procedures. We compared minimal invasive extracorporeal circulation and conventional extracorporeal circulation methods of cardiopulmonary bypass. Methods: A total of 424 patients in the minimal invasive extracorporeal circulation group and 844 patients in the conventional extracorporeal circulation group undergoing coronary artery bypass grafting and more complex cardiac surgery were evaluated. Age, sex, type of surgery, and duration of perfusion were used as matching criteria. Hemoglobin <80 g/L was used as red blood cell transfusion trigger. The primary endpoint was the use of red blood cells during the day of operation and the five postoperative days. Secondary endpoints were hemodilution (hemoglobin drop after the onset of perfusion) and postoperative bleeding from the chest tubes during the first 12 hours after the operation. Results: Red blood cell transfusions were needed less often in the minimal invasive extracorporeal circulation group compared to the conventional extracorporeal circulation group (26.4% vs. 33.4%, p = 0.011, odds ratio 0.72, 95% confidence interval 0.55-0.93), especially in coronary artery bypass grafting subgroup (21.3% vs. 35.1%, p < 0.001, odds ratio 0.50, 95% confidence interval 0.35-0.73). Hemoglobin drop after onset of perfusion was also lower in the minimal invasive extracorporeal circulation group than in the conventional extracorporeal circulation group (24.2 ± 8.5% vs. 32.6 ± 12.6%, p < 0.001). Postoperative bleeding from the chest tube did not differ between the groups (p = 0.808). Conclusion: Minimal invasive extracorporeal circulation reduced the need of red blood cell transfusions and hemoglobin drop when compared to the conventional extracorporeal circulation group. This may have implications when choosing the perfusion method in cardiac surgery.

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