An analysis of the effect of low titer O whole blood (LTOWB) proportions for resuscitation after trauma on 6-hour and 24-hour survival

Am J Surg. 2024 Nov:237:115900. doi: 10.1016/j.amjsurg.2024.115900. Epub 2024 Aug 13.

Abstract

Introduction: Hemorrhage is a leading cause of death. Blood products are used for the treatment of hemorrhagic shock. The use of low titer group O whole blood (LTOWB) has become more common.

Methods: Data from patients ≥15 years of age in the Trauma Quality Improvement Program (TQIP) database that received ≥10 units of packed red cells and/or LTOWB within the first 4-h of hospital arrival were included. The proportion of LTWOB of total blood products administered was correlated to 6- and 24-h mortality.

Results: 12,763 met inclusion, 3827 (30 %) received LTOWB. On multivariable logistic regression (MVLR), there was no difference in survival at 6 h with a LTOWB. When assessing 24-h survival, there was improved survival with LTOWB ≥10 % (OR 1.18, 1.08-1.28).

Conclusions: In this analysis of TQIP data, patients receiving ≥10 units of PRBC or LTOWB, we found that higher proportions of LTOWB transfusion relative to the total volume of blood products transfused during the first 4 h were associated with improved 24-h, but not 6-h survival.

Keywords: Blood; Hemorrhage; Transfusion; Trauma; Whole blood.

MeSH terms

  • ABO Blood-Group System*
  • Adult
  • Blood Transfusion* / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Resuscitation* / methods
  • Retrospective Studies
  • Shock, Hemorrhagic* / mortality
  • Shock, Hemorrhagic* / therapy
  • Survival Rate
  • Time Factors
  • Wounds and Injuries* / mortality
  • Wounds and Injuries* / therapy

Substances

  • ABO Blood-Group System