Outcomes of Transfusion With Whole Blood, Component Therapy, or Both in Adult Civilian Trauma Patients: A Systematic Review and Meta-Analysis

Authors

Micah Ngatuvai, Nova Southeastern UniversityFollow
Israel Zagales, Universidad Iberoamericana (UNIBE)
Matthew Sauder, Nova Southeastern UniversityFollow
Ryan Andrade, A.T. Still University School of Osteopathic Medicine
Radleigh Santos, Nova Southeastern UniversityFollow
Tracy Bilski, Orlando Regional Medical Center
Lucy Kornblith, San Francisco General Hospital and Trauma Center; University of San Francisco
Adel Elkbuli, Orlando Regional Medical Center

Document Type

Article

Publication Date

7-2023

Publication Title

Journal of Surgical Research

Keywords

Blood components, Complications, Mortality, Transfusion volume, Whole blood

ISSN

0022-4804

Volume

287

First Page

193

Last Page

201

Abstract

Introduction: This systematic review and meta-analysis was conducted to compare outcomes, including transfusion volume, complications, intensive care unit length of stay, and mortality for adult civilian trauma patients transfused with whole blood (WB), components (COMP), or both (WB þ COMP). Methods: A systematic review and meta-analysis were conducted using studies that evaluated outcomes of transfusion of WB, COMP, or WB þ COMP for adult civilian trauma patients. A search of PubMed, Embase, and Cochrane from database inception to March 3, 2022 was conducted. The search resulted in 18,400 initial articles with 16 studies remaining after the removal of duplicates and screening for inclusion and exclusion criteria. Results: This study identified an increased risk of 24-h mortality with COMP versus WB þ COMP (relative risk: 1.40 [1.10, 1.78]) and increased transfusion volumes of red blood cells with COMP versus WB at 6 and 24 h, respectively (2.26 [-3.82, 0.70]; 1.94 [-3.22, 0.65] units). There were no differences in the calculated rates of infections or intensive care unit length of stay between WB and COMP, respectively (relative risks: 1.35 [0.53, 3.46]; 0.91 [-2.64, 0.83]). Conclusions: Transfusion with WB þ COMP is associated with lower 24-h mortality versus COMP and transfusion with WB is associated with a lower volume of red blood cells transfused at both 6 and 24 h. Based on these findings, greater utilization of whole blood in civilian adult trauma resuscitation may lead to improved mortality and reduced transfusion requirements.

Comments

© 2023 Elsevier Inc. All rights reserved

NSUWorks Citation

Ngatuvai, Micah; Zagales, Israel; Sauder, Matthew; Andrade, Ryan; Santos, Radleigh; Bilski, Tracy; Kornblith, Lucy; and Elkbuli, Adel, "Outcomes of Transfusion With Whole Blood, Component Therapy, or Both in Adult Civilian Trauma Patients: A Systematic Review and Meta-Analysis" (2023). Mathematics Faculty Articles. 359.
https://nsuworks.nova.edu/math_facarticles/359

DOI

10.1016/j.jss.2023.02.010