Blood transfusions in non-major burns patients.

Adult Humans Burns / epidemiology Blood Transfusion / methods Hospitalization Length of Stay Anemia / epidemiology Wound Infection / complications Retrospective Studies
anaemia blood transfusion comorbidities non-major burns

Journal

Burns : journal of the International Society for Burn Injuries
ISSN: 1879-1409
Titre abrégé: Burns
Pays: Netherlands
ID NLM: 8913178

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 15 05 2023
revised: 07 09 2023
accepted: 26 09 2023
medline: 4 12 2023
pubmed: 23 10 2023
entrez: 22 10 2023
Statut: ppublish

Résumé

Blood transfusions are essential to treating anaemia of burn injuries. It has recently been observed that patients with non-major burns < 20%TBSA may also develop anaemia requiring transfusion of blood products. Due to the morbidity and mortality rate associated with blood transfusions better understanding of risk factors may guide clinical practices to improve patient care. To determine risk factors for transfusion of blood products in patients with non-major burn injuries and assess transfusion practices to establish impact on patient outcome. Our study included 182 adult patients with non-major burn injuries, < 20%TBSA admitted over a 3-year period at the Department of Plastic Surgery and Burns Unit of the Emergency County Hospital Cluj-Napoca. We analysed patient and injury characteristics: age, gender, %TBSA burn, %FT burn, burn site, mechanism of injury, inhalation injury, Hb lab determinations throughout admission and surgical management. Charlson comorbidities index has been determined based on cardiovascular, neurological, gastrointestinal and renal comorbidities as well as diabetes mellitus. We selected blood transfusions, wound infections and length of hospital stay as outcome for our analysis. 37.9% of patients included in our study developed anaemia throughout admission and 7.7% underwent blood transfusions. Mean Hb levels triggering blood transfusions have been recorded at 7.4 (IQR=8.8-9.9) g/dL. Patients who received transfusions were older, presented with higher %TBSA and associated a higher comorbidity index. They also tended to develop coagulopathy and underwent more surgical procedures to achieve wound closure. In transfused patients who associate comorbidities we observed a higher rate of wound infections and longer hospital stay. Patient related comorbidities correlate with higher transfusion rates in non-major burn injuries. Due to the risk associated with the use of blood products decision to transfuse should adhere to current guideline practices and be tailored to specific patient requirements.

Sections du résumé

BACKGROUND BACKGROUND
Blood transfusions are essential to treating anaemia of burn injuries. It has recently been observed that patients with non-major burns < 20%TBSA may also develop anaemia requiring transfusion of blood products. Due to the morbidity and mortality rate associated with blood transfusions better understanding of risk factors may guide clinical practices to improve patient care.
OBJECTIVE OBJECTIVE
To determine risk factors for transfusion of blood products in patients with non-major burn injuries and assess transfusion practices to establish impact on patient outcome.
METHOD METHODS
Our study included 182 adult patients with non-major burn injuries, < 20%TBSA admitted over a 3-year period at the Department of Plastic Surgery and Burns Unit of the Emergency County Hospital Cluj-Napoca. We analysed patient and injury characteristics: age, gender, %TBSA burn, %FT burn, burn site, mechanism of injury, inhalation injury, Hb lab determinations throughout admission and surgical management. Charlson comorbidities index has been determined based on cardiovascular, neurological, gastrointestinal and renal comorbidities as well as diabetes mellitus. We selected blood transfusions, wound infections and length of hospital stay as outcome for our analysis.
RESULTS RESULTS
37.9% of patients included in our study developed anaemia throughout admission and 7.7% underwent blood transfusions. Mean Hb levels triggering blood transfusions have been recorded at 7.4 (IQR=8.8-9.9) g/dL. Patients who received transfusions were older, presented with higher %TBSA and associated a higher comorbidity index. They also tended to develop coagulopathy and underwent more surgical procedures to achieve wound closure. In transfused patients who associate comorbidities we observed a higher rate of wound infections and longer hospital stay.
CONCLUSIONS CONCLUSIONS
Patient related comorbidities correlate with higher transfusion rates in non-major burn injuries. Due to the risk associated with the use of blood products decision to transfuse should adhere to current guideline practices and be tailored to specific patient requirements.

Identifiants

DOI: 10.1016/j.burns.2023.09.018 PMID: 37867053
pubmed: 37867053
pii: S0305-4179(23)00192-4
doi: 10.1016/j.burns.2023.09.018
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1808-1815

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Ioana Țichil (I)

University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj Napoca, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania; Emergency County Hospital, 3-5 Clinicilor Street, 400006 Cluj-Napoca, Romania; Department of Haematology "Ion Chiricuta" Institute of Oncology, 34-36 Republicii Street, Cluj-Napoca 400015, Romania. Electronic address: tichil.ioana@gmail.com.

Ioana Codruta Rus (IC)

Department of Haematology "Ion Chiricuta" Institute of Oncology, 34-36 Republicii Street, Cluj-Napoca 400015, Romania.

Diana Cenariu (D)

University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj Napoca, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania; MEDFUTURE - Research Centre for Advanced Medicine, 8 Louis Pasteur Street, 400347 Cluj-Napoca, Romania.

Lucian Fodor (L)

Emergency County Hospital, 3-5 Clinicilor Street, 400006 Cluj-Napoca, Romania.

Ileana Mitre (I)

University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj Napoca, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania; Emergency County Hospital, 3-5 Clinicilor Street, 400006 Cluj-Napoca, Romania.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Blood transfusions in non-major burns patients.
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Blood transfusions in non-major burns patients.
questionsmedicales.fr › Plaies et blessures › Brûlures › Blood transfusions in non-major burns patients.
questionsmedicales.fr › Thérapeutique › Biothérapie › Transfusion sanguine › Blood transfusions in non-major burns patients.
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Blood transfusions in non-major burns patients.
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Durée du séjour › Blood transfusions in non-major burns patients.
questionsmedicales.fr › Hémopathies et maladies lymphatiques › Hémopathies › Anémie › Blood transfusions in non-major burns patients.
questionsmedicales.fr › Infection › Infection de plaie › Blood transfusions in non-major burns patients.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Blood transfusions in non-major burns patients.