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Injured recipients of low‐titer group O whole blood have similar clinical outcomes compared to recipients of conventional component therapy: A single‐center, retrospective study
Author(s) -
Yazer Mark H.,
Freeman Andrew,
Harrold Ian M.,
Anto Vincent,
Neal Matthew D.,
Triulzi Darrell J.,
Sperry Jason L.,
Seheult Jansen N.
Publication year - 2021
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.16390
Subject(s) - medicine , propensity score matching , retrospective cohort study , sepsis , resuscitation , single center , titer , intensive care unit , group b , trauma center , surgery , immunology , antibody
Low‐titer group O whole blood (LTOWB) is being increasingly transfused to injured patients. This study evaluated a range of clinical outcomes to determine if receipt of LTOWB predisposed recipients to worse outcomes compared to recipients of conventional component therapy (CCT). Methods A retrospective analysis of trauma patients who received at least 3 units of LTOWB (LTOWB group) versus those that received at least 3 units of RBCs, 1 unit of plasma and 1 unit of platelets but no LTOWB (CCT group) during the first 24 h of their admission was performed. Causal treatment effects were explored using propensity score matching (PSM) and coarsened exact matching (CEM). Important clinical outcomes were evaluated. Results There were 165 CCT and 155 LTOWB recipients eligible for matching. PSM and CEM reduced covariate imbalances between the CCT and LTOWB groups, with the exception that males remained over‐represented in the LTOWB group due to the hospital's former resuscitation policy of not administering RhD‐positive LTOWB to females <50. In both of the matched analyses, the LTOWB group received a median of 4 LTOWB units. There were no significant differences in 6‐, 24‐h mortality or 30‐day mortality between groups, nor were there differences in the frequency of other clinical outcomes such as acute kidney injury, sepsis, venous/arterial thromboembolism; delta MODS was lower for the LTOWB recipients in the exact match group. Conclusion In both matched analyses, administration of a median of four LTOWB units did not result in a different frequency of major clinical outcomes including mortality.