Journal article
Use of Cold-Stored Whole Blood is Associated With Improved Mortality in Hemostatic Resuscitation of Major Bleeding A Multicenter Study
Annals of surgery, Vol.276(4), pp.579-588
01 Oct 2022
PMID: 35848743
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective: The aim of this study was to identify a mortality benefit with the use of whole blood (WB) as part of the resuscitation of bleeding trauma patients. Background: Blood component therapy (BCT) is the current standard for resuscitating trauma patients, with WB emerging as the blood product of choice. We hypothesized that the use of WB versus BCT alone would result in decreased mortality. Methods: We performed a 14-center, prospective observational study of trauma patients who received WB versus BCT during their resuscitation. We applied a generalized linear mixed-effects model with a random effect and controlled for age, sex, mechanism of injury (MOI), and injury severity score. All patients who received blood as part of their initial resuscitation were included. Primary outcome was mortality and secondary outcomes included acute kidney injury, deep vein thrombosis/pulmonary embolism, pulmonary complications, and bleeding complications. Results: A total of 1623 [WB: 1180 (74%), BCT: 443(27%)] patients who sustained penetrating (53%) or blunt (47%) injury were included. Patients who received WB had a higher shock index (0.98 vs 0.83), more comorbidities, and more blunt MOI (all P<0.05). After controlling for center, age, sex, MOI, and injury severity score, we found no differences in the rates of acute kidney injury, deep vein thrombosis/pulmonary embolism or pulmonary complications. WB patients were 9% less likely to experience bleeding complications and were 48% less likely to die than BCT patients (P<0.0001). Conclusions: Compared with BCT, the use of WB was associated with a 48% reduction in mortality in trauma patients. Our study supports the use of WB use in the resuscitation of trauma patients.
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Details
- Title
- Use of Cold-Stored Whole Blood is Associated With Improved Mortality in Hemostatic Resuscitation of Major Bleeding A Multicenter Study
- Creators
- Joshua P. Hazelton - Penn State Milton S. Hershey Medical CenterAnna E. Ssentongo - Penn State Milton S. Hershey Medical CenterJohn S. Oh - Penn State Milton S. Hershey Medical CenterPaddy Ssentongo - Penn State Milton S. Hershey Medical CenterMark J. Seamon - Hospital of the University of PennsylvaniaJames P. Byrne - Hospital of the University of PennsylvaniaIsabella G. Armento - Cooper University HospitalDonald H. Jenkins - The University of Texas Health Science Center at San AntonioMaxwell A. Braverman - The University of Texas Health Science Center at San AntonioCaleb Mentzer - Spartanburg Regional Healthcare SystemGuy C. Leonard - Spartanburg Regional Healthcare SystemLindsey L. Perea - Lancaster General HospitalCourtney K. Docherty - Philadelphia College of Osteopathic MedicineJulie A. Dunn - Banner North Colorado Medical CenterBrittany Smoot - Banner North Colorado Medical CenterMatthew J. Martin - Scripps Mercy HospitalJayraan Badiee - Scripps Mercy HospitalAlejandro J. Luis - Palmetto Health RichlandJulie L. Murray - Palmetto Health RichlandMatthew R. Noorbakhsh - Allegheny General HospitalJames E. Babowice - Allegheny General HospitalCharles Mains - St. Anthony HospitalRobert M. Madayag - St. Anthony HospitalHaytham M. A. Kaafarani - Massachusetts General HospitalAva K. Mokhtari - Massachusetts General HospitalSarah A. Moore - University of New MexicoKathleen Madden - University of New MexicoAllen Tanner - Penrose-St. Francis Health ServicesDiane Redmond - Penrose-St. Francis Health ServicesDavid J. Millia - Medical College of WisconsinAmber Brandolino - Medical College of WisconsinUyen Nguyen - Penn State Milton S. Hershey Medical CenterVernon Chinchilli - Penn State Milton S. Hershey Medical CenterScott B. Armen - Penn State Milton S. Hershey Medical CenterJohn M. Porter - Cooper University Hospital
- Publication Details
- Annals of surgery, Vol.276(4), pp.579-588
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 10
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000851142700012
- Scopus ID
- 2-s2.0-85138125816
- Other Identifier
- 991022057014504721
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- Surgery