Format

Send to

Choose Destination
Transfusion. 2018 Aug;58(8):1846-1854. doi: 10.1111/trf.14640. Epub 2018 Apr 19.

Age of transfused blood in critically ill adult trauma patients: a prespecified nested analysis of the Age of Blood Evaluation randomized trial.

Author information

1
Department of Critical Care, Dalhousie University, Halifax, Nova Scotia, Canada.
2
Trauma Nova Scotia, NS Department of Health and Wellness, Halifax, Nova Scotia, Canada.
3
Department of Pediatrics, Division of Critical Care Medicine, Université de Montréal, Centre Hospitalier Universitaire (CHU) Sainte Justine.
4
Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
5
Departments of Medicine and Laboratory Medicine & Pathology, University of Ottawa, Ottawa, Ontario, Canada.
6
Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
7
CHU de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Unit (Trauma-Emergency-Critical Care Medicine), Université Laval, Québec City, Quebec, Canada.
8
Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Québec City, Quebec, Canada.

Abstract

BACKGROUND:

Blood transfusion is common in the resuscitation of patients with traumatic injury. However, the clinical impact of the length of storage of transfused blood is unclear in this population.

STUDY DESIGN AND METHODS:

We undertook a prespecified nested analysis of 372 trauma victims of the 2510 critically ill patients from 64 centers treated as part of the Age of Blood Evaluation (ABLE) randomized controlled trial. Patients were randomized according to their trauma status to receive either a transfusion of fresh blood stored not more than 7 days or standard-issue blood. Our primary outcome was 90-day all-cause mortality.

RESULTS:

Overall, 186 trauma patients received fresh blood and 186 received standard-issue blood. Adherence to transfusion protocol was 94% (915/971) for all fresh blood transfused and 100% (753/753) for all standard-issue blood transfused. Mean ± SD blood storage duration was 5.6 ± 3.8 days in the fresh group and 22.7 ± 8.4 days in the standard-issue group (p < 0.001). Ninety-day mortality in the fresh group was 21% (38/185), compared to 16% (29/184) in the standard-issue group, with an unadjusted absolute risk difference of 5% (95% confidence interval [CI], -3.1 to 12.6) and an adjusted absolute risk difference of 2% (95% CI, -3.5 to 6.8).

CONCLUSION:

In critically ill trauma patients, transfusion of fresh blood did not decrease 90-day mortality or secondary outcomes, a finding similar to the overall population of the ABLE trial.

PMID:
29672869
DOI:
10.1111/trf.14640
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center