Nationwide analysis of cryopreserved packed red blood cell transfusion in civilian trauma

Kamil Hanna, Mohamad Chehab, Letitia Bible, Lourdes Castanon, Molly Douglas, Samer Asmar, Michael Ditillo, Andrew Tang, Bellal Joseph

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND Liquid packed red blood cells (LPRBCs) have a limited shelf life and worsening quality with age. Cryopreserved packed red blood cells (CPRBCs) can be stored up to 10 years with no quality deterioration. The effect of CPRBCs on outcomes in civilian trauma is less explored. This study aims to evaluate the safety and efficacy of CPRBCs in civilian trauma patients. METHODS We analyzed the (2015-2016) Trauma Quality Improvement Program, including adult (age, ≥18 years) patients who received a RBC transfusion within 4 hours of admission. Patients were stratified, those who received LPRBC and those who received CPRBC. Primary outcomes were 24-hour and in-hospital mortality. Secondary outcomes were major complications. Propensity matching was performed adjusting for demographics, vitals, blood components, injury parameters, comorbidities, and center parameters. RESULTS A total of 39,975 patients were identified, and a matched cohort of 483 was obtained. A total of 161 received CPRBC (CPRBC, 2 [2-4]; plasma, 2 [0-5]; platelets, 1 [0-2]) and 322 received LPRBC (LPRBC, 3 [2-6]; plasma, 3 [0-6]; platelets, 1 [0-2]). The mean age was 43 ± 22 years, 62% were men, Injury Severity Score was 18 (12-27), and 65% had a blunt injury. Patients who received CPRBC had similar 24-hour mortality (1.8% vs. 2.3%; p = 0.82) and in-hospital mortality (4.9% vs. 5.2%; p = 0.88). No difference was found in terms of complications (15.3% vs. 17.2%; p = 0.21) between the two groups. CONCLUSION Transfusion of CPRBCs may be as safe and effective as transfusion of LPRBCs in moderately injured trauma patients. Cryopreservation has the potential to expand our transfusion armamentarium in diverse settings, such as periods of increased usage, disaster scenarios, and rural areas. LEVEL OF EVIDENCE Therapeutic study, level III.

Original languageEnglish (US)
Pages (from-to)861-866
Number of pages6
JournalJournal of Trauma and Acute Care Surgery
Volume89
Issue number5
DOIs
StatePublished - Nov 1 2020

Keywords

  • Cryopreserved packed red blood cells
  • cryopreservation
  • hemorrhage
  • liquid packed red blood cells
  • trauma

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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