Department of Surgery, University of New Mexico School of Medicine, Albuquerque, NM, USA; Texas Army National Guard, Austin, TX, USA.
Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Am J Surg. 2024 Nov;237:115900. doi: 10.1016/j.amjsurg.2024.115900. Epub 2024 Aug 13.
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.
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.
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).
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.
出血是导致死亡的主要原因。血液制品用于治疗出血性休克。低滴度 O 型全血（LTOWB）的使用变得更加普遍。
纳入创伤质量改进计划（TQIP）数据库中年龄≥15 岁的患者，这些患者在入院后 4 小时内接受了≥10 单位的浓缩红细胞和/或 LTOWB。给予的 LTWOB 占总血液制品的比例与 6 小时和 24 小时死亡率相关。
12763 例符合纳入标准，其中 3827 例（30%）接受了 LTOWB。多变量逻辑回归（MVLR）显示，LTOWB 组在 6 小时的生存率没有差异。当评估 24 小时生存率时，LTOWB≥10%的生存率提高（OR 1.18，1.08-1.28）。
在对 TQIP 数据的分析中，我们发现接受≥10 单位 PRBC 或 LTOWB 的患者，在入院后 4 小时内给予的 LTOWB 相对于总血液制品输注量的比例较高，与 24 小时生存率提高相关，但与 6 小时生存率无关。
