Optimizing outcomes in the Jehovah's Witness following trauma: Special management concerns for a unique population

Chrysanthos Georgiou, Kenji Inaba, Joseph DuBose, Pedro G R Teixeira, Pantelis Hadjizacharia, Ali Salim, Carlos Brown, Peter M Rhee, Demetrios Demetriades

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The objective of this study was to describe the management of the Jehovah's Witness (JW) in an intensely active level I trauma center and review the modern therapeutic options available for the trauma care of these patients. Study design: A retrospective review of injured JWs admitted to a busy trauma center over a 13-year period was conducted. Results: Over the study period, 143 JWs were identified. Among these, 15.4% (22/143) overall and 32.3% (10/31) requiring surgical intensive care unit (SICU) admission accepted transfusion. Overall, 56.6% of JWs (81/143) required operation and 21.7% (31/143) were admitted to the SICU with a complication rate of 4.2% (6/143) and a mortality of 1.4% (2/143). One patient of the 31 patients that were admitted to the SICU received 10 ml of blood with subsequent discontinuation of the transfusion and was excluded from analysis. Of the 30 JWs admitted to the SICU, 20 (66.7%) did not receive transfusion and demonstrated mean admission and nadir hemoglobin (Hb) levels of 12.7 (±2.5) and 9.1 (±3.0) mg/dl, respectively. Ten patients accepted transfusion. This group had longer mean SICU stays (23.3 vs. 5.5 days) but similar mortality (10%, 1/10 vs. 5%, 1/20) compared to non-transfused counterparts. Only one complication (1/20, 5%) was observed in the JWs who were not transfused, compared to a 40% (4/10) complication rate in those accepting transfusion. Conclusion: Although our experience was limited, we found no significant difference in the mortality or morbidity between JW patients who received or abstained from transfusion following major trauma. We should keep in mind that the population was small, in order to extract safe conclusions regarding whether we should transfuse or not transfuse trauma patients. We can, however, see interesting insights on the value of trauma resuscitation.

Original languageEnglish (US)
Pages (from-to)383-388
Number of pages6
JournalEuropean Journal of Trauma and Emergency Surgery
Volume35
Issue number4
DOIs
StatePublished - Aug 2009
Externally publishedYes

Fingerprint

Jehovah's Witnesses
Critical Care
Intensive Care Units
Wounds and Injuries
Population
Trauma Centers
Mortality
Resuscitation
Patient Care
Hemoglobins
Morbidity

Keywords

  • Blood transfusion
  • Hemoglobin
  • Injury
  • Jehovah's Witnesses
  • Outcome assessment
  • Trauma
  • Wounds and injuries

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Critical Care and Intensive Care Medicine
  • Emergency Medicine

Cite this

Optimizing outcomes in the Jehovah's Witness following trauma : Special management concerns for a unique population. / Georgiou, Chrysanthos; Inaba, Kenji; DuBose, Joseph; Teixeira, Pedro G R; Hadjizacharia, Pantelis; Salim, Ali; Brown, Carlos; Rhee, Peter M; Demetriades, Demetrios.

In: European Journal of Trauma and Emergency Surgery, Vol. 35, No. 4, 08.2009, p. 383-388.

Research output: Contribution to journalArticle

Georgiou, C, Inaba, K, DuBose, J, Teixeira, PGR, Hadjizacharia, P, Salim, A, Brown, C, Rhee, PM & Demetriades, D 2009, 'Optimizing outcomes in the Jehovah's Witness following trauma: Special management concerns for a unique population', European Journal of Trauma and Emergency Surgery, vol. 35, no. 4, pp. 383-388. https://doi.org/10.1007/s00068-009-8246-6
Georgiou, Chrysanthos ; Inaba, Kenji ; DuBose, Joseph ; Teixeira, Pedro G R ; Hadjizacharia, Pantelis ; Salim, Ali ; Brown, Carlos ; Rhee, Peter M ; Demetriades, Demetrios. / Optimizing outcomes in the Jehovah's Witness following trauma : Special management concerns for a unique population. In: European Journal of Trauma and Emergency Surgery. 2009 ; Vol. 35, No. 4. pp. 383-388.
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abstract = "Background: The objective of this study was to describe the management of the Jehovah's Witness (JW) in an intensely active level I trauma center and review the modern therapeutic options available for the trauma care of these patients. Study design: A retrospective review of injured JWs admitted to a busy trauma center over a 13-year period was conducted. Results: Over the study period, 143 JWs were identified. Among these, 15.4{\%} (22/143) overall and 32.3{\%} (10/31) requiring surgical intensive care unit (SICU) admission accepted transfusion. Overall, 56.6{\%} of JWs (81/143) required operation and 21.7{\%} (31/143) were admitted to the SICU with a complication rate of 4.2{\%} (6/143) and a mortality of 1.4{\%} (2/143). One patient of the 31 patients that were admitted to the SICU received 10 ml of blood with subsequent discontinuation of the transfusion and was excluded from analysis. Of the 30 JWs admitted to the SICU, 20 (66.7{\%}) did not receive transfusion and demonstrated mean admission and nadir hemoglobin (Hb) levels of 12.7 (±2.5) and 9.1 (±3.0) mg/dl, respectively. Ten patients accepted transfusion. This group had longer mean SICU stays (23.3 vs. 5.5 days) but similar mortality (10{\%}, 1/10 vs. 5{\%}, 1/20) compared to non-transfused counterparts. Only one complication (1/20, 5{\%}) was observed in the JWs who were not transfused, compared to a 40{\%} (4/10) complication rate in those accepting transfusion. Conclusion: Although our experience was limited, we found no significant difference in the mortality or morbidity between JW patients who received or abstained from transfusion following major trauma. We should keep in mind that the population was small, in order to extract safe conclusions regarding whether we should transfuse or not transfuse trauma patients. We can, however, see interesting insights on the value of trauma resuscitation.",
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AU - Hadjizacharia, Pantelis

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N2 - Background: The objective of this study was to describe the management of the Jehovah's Witness (JW) in an intensely active level I trauma center and review the modern therapeutic options available for the trauma care of these patients. Study design: A retrospective review of injured JWs admitted to a busy trauma center over a 13-year period was conducted. Results: Over the study period, 143 JWs were identified. Among these, 15.4% (22/143) overall and 32.3% (10/31) requiring surgical intensive care unit (SICU) admission accepted transfusion. Overall, 56.6% of JWs (81/143) required operation and 21.7% (31/143) were admitted to the SICU with a complication rate of 4.2% (6/143) and a mortality of 1.4% (2/143). One patient of the 31 patients that were admitted to the SICU received 10 ml of blood with subsequent discontinuation of the transfusion and was excluded from analysis. Of the 30 JWs admitted to the SICU, 20 (66.7%) did not receive transfusion and demonstrated mean admission and nadir hemoglobin (Hb) levels of 12.7 (±2.5) and 9.1 (±3.0) mg/dl, respectively. Ten patients accepted transfusion. This group had longer mean SICU stays (23.3 vs. 5.5 days) but similar mortality (10%, 1/10 vs. 5%, 1/20) compared to non-transfused counterparts. Only one complication (1/20, 5%) was observed in the JWs who were not transfused, compared to a 40% (4/10) complication rate in those accepting transfusion. Conclusion: Although our experience was limited, we found no significant difference in the mortality or morbidity between JW patients who received or abstained from transfusion following major trauma. We should keep in mind that the population was small, in order to extract safe conclusions regarding whether we should transfuse or not transfuse trauma patients. We can, however, see interesting insights on the value of trauma resuscitation.

AB - Background: The objective of this study was to describe the management of the Jehovah's Witness (JW) in an intensely active level I trauma center and review the modern therapeutic options available for the trauma care of these patients. Study design: A retrospective review of injured JWs admitted to a busy trauma center over a 13-year period was conducted. Results: Over the study period, 143 JWs were identified. Among these, 15.4% (22/143) overall and 32.3% (10/31) requiring surgical intensive care unit (SICU) admission accepted transfusion. Overall, 56.6% of JWs (81/143) required operation and 21.7% (31/143) were admitted to the SICU with a complication rate of 4.2% (6/143) and a mortality of 1.4% (2/143). One patient of the 31 patients that were admitted to the SICU received 10 ml of blood with subsequent discontinuation of the transfusion and was excluded from analysis. Of the 30 JWs admitted to the SICU, 20 (66.7%) did not receive transfusion and demonstrated mean admission and nadir hemoglobin (Hb) levels of 12.7 (±2.5) and 9.1 (±3.0) mg/dl, respectively. Ten patients accepted transfusion. This group had longer mean SICU stays (23.3 vs. 5.5 days) but similar mortality (10%, 1/10 vs. 5%, 1/20) compared to non-transfused counterparts. Only one complication (1/20, 5%) was observed in the JWs who were not transfused, compared to a 40% (4/10) complication rate in those accepting transfusion. Conclusion: Although our experience was limited, we found no significant difference in the mortality or morbidity between JW patients who received or abstained from transfusion following major trauma. We should keep in mind that the population was small, in order to extract safe conclusions regarding whether we should transfuse or not transfuse trauma patients. We can, however, see interesting insights on the value of trauma resuscitation.

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KW - Wounds and injuries

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