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- Title
Inhalation Injury Does Not Influence the Amount of Blood Transfused to Major Burn Patients: A Secondary Analysis from the Transfusion Requirement in Burn Care Evaluation Study.
- Authors
Cartotto, Robert; Taylor, Sandra L; Holmes, James H; Arnoldo, Brett; Peck, Michael; Cochran, Amalia; Col, Booker T King; Bhavsar, Dhaval; Tredget, Edward E; Stapelberg, Francois; Friedman, Bruce; Mozingo, David; Greenhalgh, David; Pollock, Bradley H; Palmieri, Tina L; Cartotto, R; Taylor, S L; Holmes, J H; Arnoldo, B; Peck, M
- Abstract
Patients with major burn injuries typically require numerous blood transfusions. It is not known if an inhalation injury (INHI) directly influences the need for blood transfusion. The purpose of this study was to determine whether INHI increases the amount of blood transfused to major burn patients. A secondary analysis from the Transfusion Requirement in Burn Care Evaluation (TRIBE) study was conducted. Patients with INHI were compared with patients without INHI. The number of red blood cell (RBC) transfusions per day (RBC per day) between INHI and No INHI was analyzed with a multivariable regression. Patients with INHI (n = 78) had significantly larger burns (P = .0004), larger full-thickness burns (P = .0007), greater admission APACHE score (P < .0001), higher admission multiple organ dysfunction scores (P < .0001), and were transfused more RBC per day (P = .009) than No INHI patients (n = 267). In the multivariable regression analysis, RBC per day was significantly associated with the %TBSA burn (P < .0001), age of the patient (P = .004), the need for more than 1 day of mechanical ventilation (P < .0001), the occurrence of at least one blood stream infection (BSI; P = .044), and being assigned to the liberal transfusion arm of TRIBE (P < .001) but not the presence of INHI (P = .056). The null hypothesis that INHI exerts no influence on the amount of blood transfused could not be rejected. Larger burn size, advanced patient age, mechanical ventilation, and BSIs are important determinants of the blood transfusion rate in major burn patients.
- Subjects
INHALATION injuries; RED blood cell transfusion; BURN patients; SECONDARY analysis; BLOOD transfusion; TREATMENT for burns &; scalds; BACTEREMIA; PNEUMONIA; RESEARCH; AGE distribution; BURNS &; scalds; RESEARCH methodology; SMOKE inhalation injuries; HEALTH status indicators; APACHE (Disease classification system); EVALUATION research; MEDICAL cooperation; HOSPITAL mortality; ARTIFICIAL respiration; COMPARATIVE studies; TRAUMA severity indices
- Publication
Journal of Burn Care & Research, 2019, Vol 40, Issue 6, p757
- ISSN
1559-047X
- Publication type
journal article
- DOI
10.1093/jbcr/irz129