Koljonen V, Tuimala J, Haglund C, Tukiainen E, Vuola J, Juvonen E, Lauronen J, Krusius T
Department of Plastic Surgery, University of Helsinki and Töölö Hospital, Helsinki University Hospital, Helsinki, Finland
RS-koulutus, Helsinki, Finland.
Scand J Surg. 2016 Sep;105(3):178-85. doi: 10.1177/1457496915622127. Epub 2016 Feb 29.
Burn anemia represents a common complication following a burn injury. Burn anemia etiology carries distinct features occurring at each stage of the post-injury and treatment periods resulting from different causes. We aimed to analyze the use of blood components in Finnish burn victims and to identify patient- and injury-related factors influencing their use.
To study the use of blood products in burn patients, we used data collected from the Optimal Use of Blood registry, developed through co-operation between 10 major hospital districts and the Finnish Red Cross Blood Service. Burn patients ⩾18 years treated at the Helsinki University Hospital between 2005 and 2011 with an in-hospital stay ⩾1 day who received at least one transfusion during their hospital stay were included in this study.
Among all 558 burn patients, 192 (34%) received blood products during their hospital stay. The transfused cohort comprised 192 burn patients. The study cohort received a total of 6087 units of blood components, 2422 units of leukoreduced red blood cells, 1728 units of leukoreduced platelets, and 420 units of single-donor fresh frozen plasma or, after 2007, 1517 units of Octaplas(®) frozen plasma. All three types of blood components were administered to 29% of patients, whereas 45% received only red blood cells and 6% received only Octaplas. Transfused patients were significantly older (p < 0.001), experienced fire-/flame-related accidents and burns to multiple locations (p < 0.001), and their in-hospital mortality exceeded that for non-transfused burn patients fivefold (p < 0.05).
We show that Finnish adult burn patients received ample transfusions. The number of blood components transfused varied according to the anatomical location of the injury and patient survival. Whether the additional mortality is related directly to transfusions or is merely a manifestation of the more severe burn injury remains unknown.
烧伤后贫血是烧伤损伤后的常见并发症。烧伤贫血的病因在损伤后和治疗期间的每个阶段都有不同的特征，由不同原因引起。我们旨在分析芬兰烧伤患者血液成分的使用情况，并确定影响其使用的患者和损伤相关因素。
为研究烧伤患者血液制品的使用情况，我们使用了从最佳用血登记处收集的数据，该登记处是由10个主要医院区和芬兰红十字会血液服务机构合作建立的。纳入2005年至2011年在赫尔辛基大学医院接受治疗、年龄≥18岁、住院时间≥1天且在住院期间至少接受一次输血的烧伤患者。
在所有558例烧伤患者中，192例（34%）在住院期间接受了血液制品。输血队列包括192例烧伤患者。研究队列共接受了6087单位的血液成分，2422单位的白细胞减少红细胞、1728单位的白细胞减少血小板和420单位的单供者新鲜冰冻血浆，或在2007年后接受了1517单位的Octaplas（®）冰冻血浆。29%的患者接受了所有三种类型的血液成分，而45%的患者仅接受红细胞，6%的患者仅接受Octaplas。输血患者年龄显著更大（p<0.001），经历了与火灾/火焰相关的事故且烧伤部位多处（p<0.001），其住院死亡率是非输血烧伤患者的五倍（p<0.05）。
我们表明芬兰成年烧伤患者接受了大量输血。输注的血液成分数量根据损伤的解剖位置和患者生存情况而有所不同。额外的死亡率是直接与输血相关还是仅仅是更严重烧伤损伤的一种表现仍不清楚。
