Volume 20, Issue 4 (Winter 2023)                   bloodj 2023, 20(4): 287-297 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Kasraian L, Naderi N, Farahangiz M, Abdorahimzadeh H. Investigating blood and blood components transfusion rates and related factors in trauma patients. bloodj 2023; 20 (4) :287-297
URL: http://bloodjournal.ir/article-1-1503-en.html
Investigating blood and blood components transfusion rates and related factors in trauma patients
L. Kasraian , N. Naderi , M. Farahangiz , H. Abdorahimzadeh *
Keywords: Key words: Trauma, Blood Transfusion, Risk Factors, Hemorrhagic Shock
Full-Text [PDF 426 kb]   (641 Downloads)     |   Abstract (HTML)  (1144 Views)
Full-Text:   (1173 Views)



Sci J Iran Blood Transfus Organ 2023;20 (4): 287-297
Original Article
 
Investigating blood and blood components transfusion
rates and related factors in trauma patients
‎
Kasraian L.1,2, Naderi N.3, Farahangiz M.4, Abdul Rahimzadeh H.5



1Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
2Shiraz Blood Transfusion Center, Shiraz, Iran
3Shiraz Anesthesiology and Critical Care Research Center. Shiraz University of Medical Sciences, Shiraz, Iran
4Shiraz University of Medical Sciences, Shiraz, Iran
5Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran



Abstract
Background and Objectives
Blood transfusion is a major challenge in treating trauma patients. This study investigated blood transfusion rates and related factors in trauma patients.

Materials and Methods
This retrospective cross-sectional study analyzed 849 trauma patients admitted to a trauma center in Shiraz, Iran during 2019-2021. Blood components usage and its relation to demographics, clinical status, lab values, and ABC score were assessed. The frequency of massive blood transfusion and the average number of blood units and blood components  consumed in these patients were surveyed. Data were analyzed by T-test, Chi-squared test, and logistic regression with SPSS-23.

Results
The mean age was 38.6 ± 19.40 years and 80.9% were male. The mean blood units, platelets, and plasma used were 5.74 ± 4.57, 1.21 ± 4.87, 2.73 ± 4.32, respectively. 62.01% received massive transfusion with mean blood, platelets, and plasma units used being 8.17 ± 5.21, 3.92 ± 4.88 and 1.85 ± 6.01, respectively. Blood use correlated with systolic/diastolic pressures, blood sugar, lymphocyte count, pH, bicarbonate, base deficit, and hematocrit. 13.3% had positive ABC score and received more blood products (p < 0.001).

Conclusions 
Blood transfusion in trauma patients depends on various clinical and lab factors. Identifying high-risk patients requiring urgent blood transfusion and rapid preparation of blood products is vital for optimizing trauma patient management and outcome.

Key words: Trauma, Blood Transfusion, Risk Factors, Hemorrhagic Shock




Received:  11  Jul  2023
Accepted: 13 Nov 2023



Correspondence: Abdul Rahimzadeh H., Specialist in Surgery. Associate Professor of Trauma Research Center, Shiraz University of Medical Sciences.
P.O.Box: 15711-71948, Shiraz,  Iran. Tel: (+9871) 36234504; Fax: (+9871) 36234504
E-mail:
1- 
1- Bio


    References:
  1.            Søreide K. Epidemiology of major trauma. Br J Surg 2009; 96(7): 697-8.
  2. Azami-Aghdash S, Sadeghi-Bazargani H, Shabaninejad H, Gorji HA. Injury epidemiology in Iran: a systematic review.  J Inj Violence Res 2017; 9(1): 27.
  3. Zargar M, Motamedi SMRK, Karbakhsh M, Ghodsi SM, Rahimi-Movaghar V, Panahi F, et al. Trauma care system in Iran. Chin J Traumatol 2011; 14(3): 131-6.
  4. Sobrino J, Shafi S. Timing and causes of death after injuries. Proc (Bayl Univ Med Cent) 2013; 26(2): 120-3.
  5. Eastridge BJ, Holcomb JB, Shackelford S. Outcomes of traumatic hemorrhagic shock and the epidemiology of preventable death from injury. Transfusion 2019; 59(S2): 1423-8.
  6. Shah A, Kerner V, Stanworth S, Agarwal S. Major haemorrhage: past, present and future. Anaesthesia 2023; 78(1): 93-104.
  7. Spasiano A, Barbarino C, Marangone A, Orso D, Trillò G, Giacomello R, et al. Early thromboelastography in acute traumatic coagulopathy: an observational study focusing on pre-hospital trauma care. Eur J Trauma Emerg Surg 2022; 48(1): 431-9. 
  8. Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, et al. Transfusion of plasma, platelets, and red blood cells in a 1: 1: 1 vs a 1: 1: 2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA 2015; 313(5): 471-82.
  9.            Cushing M, Shaz B. Blood transfusion in trauma patients: unresolved questions. Minerva Anestesiol 2011; 77(3): 349-59.
  10.            Hanna M, Knittel J, Gillihan J. The use of whole blood transfusion in trauma. Curr Anesthesiol Rep 2022; 12(2): 234-9.
  11.            Moore FA, Nelson T, McKinley BA, Moore EE, Nathens AB, Rhee P, et al. Massive transfusion in trauma patients: tissue hemoglobin oxygen saturation predicts poor outcome. J Trauma 2008;64(4):1010-23.
  12.            Ogura T, Nakamura Y, Nakano M, Izawa Y, Nakamura M, Fujizuka K, et al. Predicting the need for massive transfusion in trauma patients: the Traumatic Bleeding Severity Score. J Trauma 2014; 76(5): 1243-50.
  13.            Maegele M. Challenges to improving patient outcome following massive transfusion in severe trauma. Expert Rev Hematol 2020; 13(4): 323-30.
  14.            Pham H, Shaz B. Update on massive transfusion. Br J Anaesth 2013; 111(suppl_1): i71-i82.
  15.            Rau CS, Wu SC, Kuo SC, Pao-Jen K, Shiun-Yuan H, Chen YC, et al. Prediction of massive transfusion in trauma patients with shock index, modified shock index, and age shock index. Int J Environ Res Public Health 2016; 13(7): 683.
  16.            Laing ML, Burtch K, Storrer A, McCoy C. Standardized Calcium Replacement in Massive
Transfusion: A Quality Improvement Project. J Trauma Nurs 2023; 30(5): 290-5.
  1.            Cotton BA, Dossett LA, Haut ER, Shafi S, Nunez TC, Au BK, et al. Multicenter validation of a simplified score to predict massive transfusion in trauma. J Trauma 2010; 69(1): S33-S9.
  2. Cantle PM, Cotton BA. Prediction of massive transfusion in trauma. Crit Care Clin 2017; 33(1): 71-84.
  3.            Meißner A, Schlenke P. Massive bleeding and massive transfusion. Transfus Med Hemother 2012; 39(2): 73-84.
  4.            Chidester SJ, Williams N, Wang W, Groner JI. A pediatric massive transfusion protocol. J Trauma Acute Care Surg 2012; 73(5): 1273-7.
  5.            Sihler KC, Napolitano LM. Complications of massive transfusion. Chest 2010; 137(1): 209-20.
  6.            Vandromme MJ, Griffin RL, Kerby JD, McGwin Jr G, Rue III LW, Weinberg JA. Identifying risk for massive transfusion in the relatively normotensive patient: utility of the prehospital shock index. J Trauma Acute Care Surg 2011; 70(2): 384-90.
  7.            Hamidi M, Zeeshan M, Kulvatunyou N, Adun E, O'Keeffe T, Gries L, et al. Outcomes after massive transfusion in trauma patients: variability among trauma centers. J Surg Res 2019; 234: 110-5.
  8.            Malone DL, Dunne J, Tracy JK, Putnam AT, Scalea TM, Napolitano LM. Blood transfusion, independent of shock severity, is associated with worse outcome in trauma. J Trauma Acute Care Surg 2003; 54(5): 898-907.
  9.            Lammers D, Marenco C, Morte K, Conner J, Williams J, Bax T, et al. Machine learning for military trauma: novel massive transfusion predictive models in combat zones. J Surg Res 2022; 270: 369-75.
  10.            Meneses E, Boneva D, McKenney M, Elkbuli A. Massive transfusion protocol in adult trauma population. Am J Emerg Med 2020; 38(12): 2661-6.
  11.            Abuzeid AM, O’Keeffe T. Review of massive transfusion protocols in the injured, bleeding patient. Curr Opin Crit Care 2019; 25(6): 661-7.
  12.            Mina MJ, Winkler AM, Dente CJ. Let technology do the work: improving prediction of massive transfusion with the aid of a smartphone application. J Trauma Acute Care Surg 2013; 75(4): 669.
  13.            Livingston MH, Singh S, Merritt NH. Massive transfusion in paediatric and adolescent trauma patients: incidence, patient profile, and outcomes prior to a massive transfusion protocol. Injury 2014; 45(9): 1301-6.
  14.            Akaraborworn O, Siribumrungwong B, Sangthong B, Thongkhao K. Massive blood transfusion for trauma score to predict massive blood transfusion in trauma. Crit Care Res Pract 2021; 2021: 3165390.
  15.            Mclennan JV, Mackway-Jones KC, Smith JE. Prediction of massive blood transfusion in battlefield trauma: development and validation of the Military Acute Severe Haemorrhage (MASH) score. Injury 2018; 49(2): 184-90.
  16.            Pommerening MJ, Goodman MD, Holcomb JB, Wade CE, Fox EE, Del Junco DJ, et al. Clinical gestalt and the prediction of massive transfusion after trauma. Injury 2015; 46(5): 807-13.
  17.            Shih AW, Al Khan S, Wang AYH, Dawe P, Young PY, Greene A, et al. Systematic reviews of scores and predictors to trigger activation of massive transfusion protocols. J Trauma Acute Care Surg 2019; 87(3): 717-
  18.            Broxton S, Medeiros R, Abuzeid A, Peterson C, Schumacher A. Implementation of a massive transfusion protocol: evaluation of its use and efficacy. J Trauma Nurs 2018; 25(2): 92-7.
  19.            Motameni AT, Hodge RA, McKinley WI, Georgel JM, Strollo BP, Benns MV, et al. The use of ABC score in activation of massive transfusion: The yin and the yang. J Trauma Acute Care Surg 2018; 85(2): 298-302.
  20. Nunez TC, Voskresensky IV, Dossett LA, Shinall R, Dutton WD, Cotton BA. Early prediction of massive transfusion in trauma: simple as ABC (assessment of blood consumption)? J Trauma Acute Care Surg 2009; 66(2): 346-52.
Type of Study: Research | Subject: Blood transfusion medicine
Add your comments about this article : Your username or Email:
CAPTCHA
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2025 CC BY-NC 4.0 | Journal of Iranian Blood Transfusion

Designed & Developed by: Yektaweb