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Transfusion of blood components containing ABO ‐incompatible plasma does not lead to higher mortality in civilian trauma patients
Author(s) -
Seheult Jansen N.,
Dunbar Nancy M.,
Hess John R.,
Tuott Erin E.,
Bahmanyar Mohammad,
Campbell Jessica,
Fontaine Magali,
Khan Jenna,
Ko Ara,
Mi Jian,
Murphy Michael F.,
Nykoluk Tara,
Poisson Jessica,
Raval Jay S.,
Shih Andrew,
Sperry Jason L.,
Staves Julie,
Wong Michelle,
Yan Matthew T. S.,
Ziman Alyssa,
Yazer Mark H.
Publication year - 2020
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.16008
Subject(s) - abo blood group system , medicine , logistic regression , resuscitation , injury severity score , blood transfusion , mortality rate , emergency medicine , poison control , injury prevention
Background This study investigated the effect on mortality of transfusing ABO‐incompatible plasma from all sources during trauma resuscitation. Methods Demographic, transfusion, and survival data were retrospectively extracted on civilian trauma patients. Patients were divided by receipt of any quantity of ABO‐incompatible plasma from any blood product (incompatible group) or receipt of solely ABO‐compatible plasma (compatible group). The primary outcome was 30‐day mortality, while other outcomes included 6‐ and 24‐hour mortality. Mixed‐effects logistic regression was used to model the effect of various predictor variables, including receipt of incompatible plasma, on mortality outcomes. Results Nine hospitals contributed data on a total of 2618 trauma patients. There were 1282 patients in the incompatible group and 1336 patients in the compatible group. In both the unadjusted and adjusted models, the 6‐hour, 24‐hour, and 30‐day mortality rates were not significantly different between these groups. The patients in the incompatible group were then divided into high volume (>342 mL) and low volume (≤342 mL) incompatible plasma recipients. In the adjusted model, the high‐volume group had higher 24‐hour mortality when the Trauma Injury Severity Score survival prediction was >50%. Mortality at 6 hours and 30 days was not higher in this model. The low‐volume group did not have increased mortality at any of the time points in this adjusted model. Conclusion The transfusion of incompatible plasma in civilian trauma resuscitation does not lead to higher 30‐day mortality. The finding of higher mortality in a select group of recipients in the secondary analysis warrants further study.