Predictors Indicating the Need for Packed Red Cell Transfusion in Trauma Patients in a Referral Hospital in Tehran Iran

Seyed Amir Miratashi  Yazdi; Fatemeh  Rashidi; Alireza  Samimiat; Sara  Mirzamohammadi; Shireen Shams  Ardekani; Seyed Ahmad Seyed  Alinaghi; Mohammadreza  Zafarghandi

doi:10.18502/jimc.v8i4.19540

Seyed Amir Miratashi Yazdi Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
Fatemeh Rashidi School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Alireza Samimiat Department of Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Sara Mirzamohammadi Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
Shireen Shams Ardekani Department of Pathology, School of Medicine, University of Chicago, Chicago, IL, USA
Seyed Ahmad Seyed Alinaghi Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
Mohammadreza Zafarghandi Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v8i4.19540

Keywords: Blood transfusion, Hemorrhage, Trauma centers, Wounds

Abstract

Background: Injury is one of the leading causes of death worldwide. Additionally, acute traumatic hemorrhage is one of the leading reasons for mortality in traumatic patients. This study aims to determine factors indicating Packed Red Cell (PRC) transfusion in traumatic patients.

Methods: This case-control study was conducted at Sina Hospital in Tehran, Iran, from July 24, 2016, to April 8, 2023. The case group included all trauma patients aged 18 yrs and older who received PRC transfusions within 72 hr after admission. The control group comprised trauma patients aged 18 yrs and older who received no blood transfusion during their hospitalization.

Results: Patients with PRC transfusion had lower Hemoglobin (Hb) levels, bicarbonate levels, Diastolic Blood Pressure (DBP), higher tachycardia rate, lower Mean Arterial Pressure (MAP), lower Base Excess (BE), higher positive Focused Assessment with Sonography in Trauma (FAST) results, and penetrating injuries than the control group. Multivariate logistic regression revealed Hb≤10 g/dl had 5.449 times more odds for PRC transfusion [OR: 5.449, p<0.001]. Also, DBP≤70 mm/Hg increased 1.563 times PRC transfusion’s chance [OR: 1.563, p=0.036]. Patients with penetrating injury had 2.035 times more odds for PRC transfusion compared to the blunt victims [OR: 2.035, p=0.01]. Other predictors were MAP less than 65 and tachycardia [Pulse Rate (PR)>100] with 4.574 and 4.056 odds of ratio, respectively [OR: 4.574, 4.056, p=0.02, <0.001].

Conclusion: This study revealed hemoglobin levels, penetrating trauma, and shock indexes included DBP, MAP, and tachycardia as predictors for PRC transfusion.