Older Blood Is Associated With Increased Mortality and Adverse Events in Massively Transfused Trauma Patients: Secondary Analysis of the PROPPR Trial.
Journal
Annals of emergency medicine
ISSN: 1097-6760
Titre abrégé: Ann Emerg Med
Pays: United States
ID NLM: 8002646
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
30
03
2018
revised:
24
08
2018
accepted:
28
09
2018
pubmed:
19
11
2018
medline:
6
2
2020
entrez:
19
11
2018
Statut:
ppublish
Résumé
The transfusion of older packed RBCs may be harmful in critically ill patients. We seek to determine the association between packed RBC age and mortality among trauma patients requiring massive packed RBC transfusion. We analyzed data from the Pragmatic, Randomized Optimal Platelet and Plasma Ratios trial. Subjects in the parent trial included critically injured adult patients admitted to 1 of 12 North American Level I trauma centers who received at least 1 unit of packed RBCs and were predicted to require massive blood transfusion. The primary exposure was volume of packed RBC units transfused during the first 24 hours of hospitalization, stratified by packed RBC age category: 0 to 7 days, 8 to 14 days, 15 to 21 days, and greater than or equal to 22 days. The primary outcome was 24-hour mortality. We evaluated the association between transfused volume of each packed RBC age category and 24-hour survival, using random-effects logistic regression, adjusting for total packed RBC volume, patient age, sex, race, mechanism of injury, Injury Severity Score, Revised Trauma Score, clinical site, and trial treatment group. The 678 patients included in the analysis received a total of 8,830 packed RBC units. One hundred patients (14.8%) died within the first 24 hours. On multivariable analysis, the number of packed RBCs greater than or equal to 22 days old was independently associated with increased 24-hour mortality (adjusted odds ratio [OR] 1.05 per packed RBC unit; 95% confidence interval [CI] 1.01 to 1.08): OR 0.97 for 0 to 7 days old (95% CI 0.88 to 1.08), OR 1.04 for 8 to 14 days old (95% CI 0.99 to 1.09), and OR 1.02 for 15 to 21 days old (95% CI 0.98 to 1.06). Results of sensitivity analyses were similar only among patients who received greater than or equal to 10 packed RBC units. Increasing quantities of older packed RBCs are associated with increased likelihood of 24-hour mortality in trauma patients receiving massive packed RBC transfusion (≥10 units), but not in those who receive fewer than 10 units.
Identifiants
pubmed: 30447946
pii: S0196-0644(18)31326-X
doi: 10.1016/j.annemergmed.2018.09.033
pmc: PMC6517091
mid: NIHMS1512726
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT01545232']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
650-661Subventions
Organisme : NHLBI NIH HHS
ID : U01 HL077863
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL077881
Pays : United States
Organisme : CIHR
ID : CRR-120612
Pays : Canada
Investigateurs
John B Holcomb
(JB)
Charles E Wade
(CE)
Deborah J Del Junco
(DJ)
Erin E Fox
(EE)
Nena Matijevic
(N)
Jeanette Podbielski
(J)
Angela M Beeler
(AM)
Barbara C Tilley
(BC)
Sarah Baraniuk
(S)
Hongjian Zhu
(H)
Joshua Nixon
(J)
Roann Seay
(R)
Savitri N Appana
(SN)
Hui Yang
(H)
Michael O Gonzalez
(MO)
Lisa Baer
(L)
Yao-Wei W Wang
(YW)
Brittany S Hula
(BS)
Elena Espino
(E)
An Nguyen
(A)
Nicholas Pawelczyk
(N)
Kisha D Arora-Nutall
(KD)
Rishika Sharma
(R)
Jessica C Cardenas
(JC)
Elaheh Rahbar
(E)
Tyrone Burnett
(T)
David Clark
(D)
Gerald van Belle
(G)
Susanne May
(S)
Brian Leroux
(B)
David Hoyt
(D)
Judy Powell
(J)
Kellie Sheehan
(K)
Alan Hubbard
(A)
Adam P Arkin
(AP)
John R Hess
(JR)
Jeanne Callum
(J)
Bryan A Cotton
(BA)
Laura Vincent
(L)
Timothy Welch
(T)
Tiffany Poole
(T)
Evan G Pivalizza
(EG)
Sam D Gumbert
(SD)
Yu Bai
(Y)
James J McCarthy
(JJ)
Amy Noland
(A)
Rhonda Hobbs
(R)
Eileen M Bulger
(EM)
Patricia Klotz
(P)
Lindsay Cattin
(L)
Keir J Warner
(KJ)
Angela Wilson
(A)
David Boman
(D)
Nathan White
(N)
Andreas Grabinsky
(A)
Jennifer A Daniel-Johnson
(JA)
Mitchell J Cohen
(MJ)
Rachael A Callcut
(RA)
Mary Nelson
(M)
Brittney Redick
(B)
Amanda Conroy
(A)
Marc P Steurer
(MP)
Preston C Maxim
(PC)
Eberhard Fiebig
(E)
Joanne Moore
(J)
Eireen Mallari
(E)
Peter Muskat
(P)
Jay A Johannigman
(JA)
Bryce R H Robinson
(BRH)
Richard D Branson
(RD)
Dina Gomaa
(D)
Christopher Barczak
(C)
Suzanne Bennett
(S)
Patricia M Carey
(PM)
Christopher N Miller
(CN)
Helen Hancock
(H)
Carolina Rodriguez
(C)
Kenji Inaba
(K)
Jay G Zhu
(JG)
Monica D Wong
(MD)
Michael Menchine
(M)
Kelly Katzberg
(K)
Sean O Henderson
(SO)
Rodney McKeever
(R)
Ira A Shulman
(IA)
Janice M Nelson
(JM)
Christopher W Tuma
(CW)
Cheryl Y Matsushita
(CY)
Thomas M Scalea
(TM)
Deborah M Stein
(DM)
Cynthia K Shaffer
(CK)
Christine Wade
(C)
Anthony V Herrera
(AV)
Seeta Kallam
(S)
Sarah E Wade
(SE)
Samuel M Galvagno
(SM)
Magali J Fontaine
(MJ)
Janice M Hunt
(JM)
Rhonda K Cooke
(RK)
Timothy C Fabian
(TC)
Jordan A Weinberg
(JA)
Martin A Croce
(MA)
Suzanne Wilson
(S)
Stephanie Panzer-Baggett
(S)
Lynda Waddle-Smith
(L)
Sherri Flax
(S)
Karen J Brasel
(KJ)
Pamela Walsh
(P)
David Milia
(D)
Allia Nelson
(A)
Olga Kaslow
(O)
Tom P Aufderheide
(TP)
Jerome L Gottschall
(JL)
Erica Carpenter
(E)
Terence O'Keeffe
(T)
Laurel L Rokowski
(LL)
Kurt R Denninghoff
(KR)
Daniel T Redford
(DT)
Deborah J Novak
(DJ)
Susan Knoll
(S)
Jeffrey D Kerby
(JD)
Jean-Francois Pittet
(JF)
Patrick L Bosarge
(PL)
Albert T Pierce
(AT)
Carolyn R Williams
(CR)
Shannon W Stephens
(SW)
Henry E Wang
(HE)
Marisa B Marques
(MB)
Martin A Schreiber
(MA)
Jennifer M Watters
(JM)
Samantha J Underwood
(SJ)
Tahnee Groat
(T)
Craig Newgard
(C)
Matthias Merkel
(M)
Richard M Scanlan
(RM)
Beth Miller
(B)
Sandro Rizoli
(S)
Homer Tien
(H)
Barto Nascimento
(B)
Sandy Trpcic
(S)
Skeeta Sobrian-Couroux
(S)
Marciano Reis
(M)
Adic Pérez
(A)
Susan E Belo
(SE)
Lisa Merkley
(L)
Connie Colavecchia
(C)
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
Références
J Trauma. 2006 Jun;60(6 Suppl):S3-11
pubmed: 16763478
Transfusion. 2012 Jun;52(6):1184-95
pubmed: 22188419
N Engl J Med. 2016 Nov 17;375(20):1937-1945
pubmed: 27775503
J Trauma Acute Care Surg. 2012 Aug;73(2 Suppl 1):S128-33
pubmed: 22847082
J Surg Res. 2013 Sep;184(1):422-9
pubmed: 23830370
Anesthesiology. 2012 Dec;117(6):1190-202
pubmed: 23168426
Injury. 2014 May;45(5):819-24
pubmed: 24529718
Cancer Control. 2015 Jan;22(1):26-37
pubmed: 25504276
Free Radic Biol Med. 2015 Aug;85:207-18
pubmed: 25933588
J Trauma. 2011 Dec;71(6):1766-73; discussion 1773-4
pubmed: 22182887
Transfus Med Rev. 2015 Apr;29(2):120-6
pubmed: 25573415
Blood. 2009 Jan 29;113(5):1158-66
pubmed: 19064726
Anaesthesia. 2015 Jan;70 Suppl 1:29-37, e9-12
pubmed: 25440392
Transfusion. 2009 Nov;49(11):2304-10
pubmed: 19624601
J Trauma. 2011 Feb;70(2):466-71
pubmed: 21307749
Lancet Haematol. 2017 Nov;4(11):e544-e552
pubmed: 29021123
N Engl J Med. 2015 Apr 9;372(15):1419-29
pubmed: 25853746
JAMA. 2015 Feb 3;313(5):471-82
pubmed: 25647203
Crit Care Med. 2013 Nov;41(11):2492-501
pubmed: 23887236
J Trauma Acute Care Surg. 2013 Feb;74(2):396-400; discussion 400-2
pubmed: 23354230
Transfusion. 2015 Dec;55(12):2967-78
pubmed: 26202471
Blood. 2014 Feb 27;123(9):1403-11
pubmed: 24366359
N Engl J Med. 2015 Apr 9;372(15):1410-8
pubmed: 25853745
Vox Sang. 2014 Jul;107(1):1-9
pubmed: 24446817
N Engl J Med. 2017 Nov 9;377(19):1858-1867
pubmed: 28952891
Transfusion. 2012 Dec;52(12):2533-50
pubmed: 22452342