Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado, USA.
Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Transfusion. 2024 May;64 Suppl 2:S85-S92. doi: 10.1111/trf.17746. Epub 2024 Feb 13.
The use of low titer O whole blood (LTOWB) has expanded although it remains unclear how many civilian trauma centers are using LTOWB.
We analyzed data on civilian LTOWB recipients in the American College of Surgeons Trauma Quality Improvement Program (TQIP) database 2020-2021. Unique facility keys were used to determine the number of centers that used LTOWB in that period.
A total of 16,603 patients received LTOWB in the TQIP database between 2020 and 2021; 6600 in 2020, and 10,003 in 2021. The total number of facilities that reported LTOWB use went from 287/779 (37%) in 2020 to 302/795 (38%) in 2021. Between 2020 and 2021, among all level 1-3 designated trauma facilities that report to TQIP LTOWB use increased at level-1 centers (118 to 129), and level-2 centers (81 to 86), but decreased in level-3 facilities (9 to 4). Among pediatric and dual pediatric-adult designated hospitals there was a decrease in the number of pediatric level-1 centers (29 to 28) capable of administering LTOWB. Among centers with either single or dual level-1 trauma center designation with adult centers, the number that administered LTOWB to injured pediatric patients also decreased from 17 to 10, respectively.
There was an increase in the number of facilities transfusing LTOWB between 2020 and 2021. The use of LTOWB is underutilized in children at centers that have it available. These findings inform the expansion of LTOWB use in trauma.
尽管仍不清楚有多少民用创伤中心正在使用低滴度 O 全血(LTOWB),但其使用范围已经扩大。
我们分析了 2020 年至 2021 年期间美国外科医师学会创伤质量改进计划(TQIP)数据库中接受 LTOWB 的民用患者的数据。使用独特的设施密钥来确定在此期间使用 LTOWB 的中心数量。
在 2020 年至 2021 年期间,TQIP 数据库中有 16603 名患者接受了 LTOWB;2020 年有 6600 名,2021 年有 10003 名。报告使用 LTOWB 的设施总数从 2020 年的 287/779(37%)增加到 2021 年的 302/795(38%)。在向 TQIP 报告的所有 1-3 级指定创伤设施中,2020 年至 2021 年期间,LTOWB 的使用在 1 级中心(从 118 增加到 129)和 2 级中心(从 81 增加到 86)有所增加,但在 3 级设施(从 9 减少到 4)有所减少。在儿科和双儿科-成人指定医院中,能够使用 LTOWB 的儿科 1 级中心数量从 29 减少到 28。在具有单一或双重 1 级创伤中心指定的成人中心的中心中,对受伤儿科患者进行 LTOWB 治疗的中心数量也从 17 减少到 10。
2020 年至 2021 年间,使用 LTOWB 的设施数量有所增加。在有 LTOWB 的情况下,中心对儿童的使用不足。这些发现为创伤中 LTOWB 的使用扩展提供了信息。