Evaluation of the Pattern and Outcome of Blood Transfusion in Severely Injured Patients Admitted to a Trauma Intensive Care Unit in Nigeria: Report of Early Results

Abstract

Background

Anaemia often necessitating blood transfusion is common in critically ill trauma patients admitted into the Intensive Care Unit. The aetiology of the anaemia in trauma patients is often multi-factorial. It may result from the trauma event, from subsequent investigations and treatment, and or from complications of the injury. Presently, there is limited number of quality studies on blood transfusion and outcome among trauma patients admitted into the intensive care units in Nigeria.

Aim:  To evaluate the pattern and outcome of red blood cell transfusion in severely injured adult patients admitted into a trauma ICU in Nigeria.

Method

Prospective observational study without intervention on transfusion pattern and outcome in adult patients admitted to the trauma ICU between October 1, 2010 and July 31, 2011.

Results

One hundred and twenty-two adult patients (31.3%) amongst the 390 patients admitted to the trauma ICU received 357 units of RBC. Most of the transfused patients were between the ages of 20 and 39 years (n = 48 {12.4 %}). The need to receive blood transfusion was strongly related to the severity of injury as assessed by Injury Severity Score (ISS) and Simplified Acute Physiology Score II (r = 0.13, p = 0.013). There was a strong correlation between the units of blood transfused to each patient and the severity of injury (R = 0.3708, P < 0.00001) but that association was weakly correlated with the Simplified Acute Physiology Score II Spearman’s correlation rho = 0.056, P = 0.61).  Blood transfusion was also significantly associated with a higher risk of developing a complication (OR {CI} = 6.57 {4.05 – 10.67}) and a statistically insignificant higher risk of death Chi- sq. = 3.703, p = 0.054).

Conclusions: Blood transfusion is a common intervention in severely injured  patients admitted to the trauma ICU.  Red cell transfusion was directly related to the severity of the injury and was associated with poorer outcome.

Keywords: Anaemia, Trauma, Trauma ICU, RBC transfusion, Outcome.