Featured Research

from universities, journals, and other organizations

Transfusion after trauma can benefit or harm patients depending on their risk of death

Date:
June 17, 2014
Source:
PLOS
Summary:
The risks and benefits of red blood cell transfusions for patients with trauma and major bleeding might vary considerably based on a patient's predicted risk of death on arrival at a trauma center, according to new research.

The risks and benefits of red blood cell transfusions for patients with trauma and major bleeding might vary considerably based on a patient's predicted risk of death on arrival at a trauma centre, according to new research published in this week's PLOS Medicine. The study by Pablo Perel, from the London School of Hygiene & Tropical Medicine, United Kingdom, and colleagues, suggests that trauma patients who have the highest predicted risk of death on arrival at a trauma centre receive the greatest benefit from red blood cell transfusions but for those with the lowest predicted risk of death at baseline red blood cell transfusion is associated with a higher chance of death.

Related Articles


The authors of the study used data from the CRASH-2 trial that evaluated the effect of tranexamic acid (which reduces blood loss) in patients with trauma, which included 20,127 trauma patients with significant bleeding from 274 hospitals in 40 countries. The authors evaluated the association between receiving red blood cell transfusion versus not receiving a red blood cell transfusion with deaths by all causes at 28 days post trauma. The findings were stratified by predicted risk of death based on clinical observations on arrival at the trauma centre.

The authors found that those at greatest predicted risk of dying (>50%) had a smaller chance of death from all causes if they were transfused (an odds ratio (OR) of 0.59 (95% confidence interval [CI] 0.47-0.74)), while for those in the 21%-50% risk group there was no significant difference in their chance of dying based on whether they are transfused or not (OR 0.92, 95% CI 0.78-1.08). However, for those within the lower risk strata, transfusion was associated not with benefit but with harm. Patients at a 6%-20% chance of death had an OR of 2.31 (95% CI 1.96-2.73) for dying if they received a transfusion, while for those whose initial risk was below 6%, the OR for death associated with transfusion was 5.40 (95% CI 4.08- 7.13). In absolute figures, compared to no transfusion, RBC transfusion was associated with 5.1 (95% CI 4.3 to 6.0) more deaths per 100 patients in the patient group with the lowest predicted risk of death but with 11.9 (95% CI 7.1 to 16.7) fewer deaths per 100 patients in the group with the highest predicted risk of death.

The authors caution, "[o]ur study suggests that blood transfusion could be harmful for those patients whose predicted risk of death is low. However, as our study was observational, important biases cannot be ruled out, and we cannot claim a causal link. Therefore, this hypothesis should be prospectively evaluated in a randomised controlled trial."

In an accompanying Perspective article PLOS Medicine Consulting Editor Druin Burch notes, "[w]ith so many dying each year, and with deaths from injury set to rise in importance as road traffic crashes and violent injuries account for a greater portion of the global burden of disease, we have a compelling reason to improve and rationalize our transfusion strategies."


Story Source:

The above story is based on materials provided by PLOS. Note: Materials may be edited for content and length.


Journal Reference:

  1. Perel P, Clayton T, Altman DG, Croft P, Douglas I, et al. Red Blood Cell Transfusion and Mortality in Trauma Patients: Risk-Stratified Analysis of an Observational Study. PLoS Med, 2014 DOI: 10.1371/journal.pmed.10016

Cite This Page:

PLOS. "Transfusion after trauma can benefit or harm patients depending on their risk of death." ScienceDaily. ScienceDaily, 17 June 2014. <www.sciencedaily.com/releases/2014/06/140617210839.htm>.
PLOS. (2014, June 17). Transfusion after trauma can benefit or harm patients depending on their risk of death. ScienceDaily. Retrieved March 30, 2015 from www.sciencedaily.com/releases/2014/06/140617210839.htm
PLOS. "Transfusion after trauma can benefit or harm patients depending on their risk of death." ScienceDaily. www.sciencedaily.com/releases/2014/06/140617210839.htm (accessed March 30, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, March 30, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Soda, Salt and Sugar: The Next Generation of Taxes

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015) — Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline. Video provided by Washington Post
Powered by NewsLook.com
UnitedHealth Buys Catamaran

UnitedHealth Buys Catamaran

Reuters - Business Video Online (Mar. 30, 2015) — The $12.8 billion merger will combine the U.S.&apos; third and fourth largest pharmacy benefit managers. Analysts say smaller PBMs could also merge. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
S. Leone in New Anti-Ebola Lockdown

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015) — Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17 Video provided by AFP
Powered by NewsLook.com
These Popular Antibiotics Can Cause Permanent Nerve Damage

These Popular Antibiotics Can Cause Permanent Nerve Damage

Newsy (Mar. 27, 2015) — A popular class of antibiotic can leave patients in severe pain and even result in permanent nerve damage. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins