Packed red blood cell transfusion: a catalyst for thrombosis in patients with traumatic brain injury?

IF 1.8 4区医学 Q4 NEUROSCIENCES Brain injury Pub Date : 2025-01-01 Epub Date: 2025-03-24 DOI:10.1080/02699052.2025.2481613

Lily Nguyen, Jeffry Nahmias, Patrick Chen, Jefferson Chen, Michael Lekawa, Jordan Shin, Areg Grigorian

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Abstract

Introduction: This study investigated the relationship between trauma patients with TBI who did and did not receive blood product transfusions and the incidence of venous thromboembolism (VTE) hypothesizing transfusions increase VTE risk.

Methods: The Trauma Quality Improvement Program (TQIP) was queried from 2017 to 2021 to identify adult (≥18 years-old) patients with TBI. Patients with TBI receiving any blood product transfusions within 4 h of arrival were compared to those who did not. Outcomes were compared using bivariate analyses and a multivariable logistic regression to identify predictors of VTE.

Results: Of 451,061 patients with TBI, 32,276 (7.2%) patients received a blood transfusion. Thrombotic events were more frequently observed in transfused patients such as VTE (7.6% vs 1.4%, p < 0.001), comprised of deep vein thrombosis (6.0% vs 1.1%, p < 0.001) and pulmonary embolism (2.3% vs 0.4%, p < 0.001). Blood product transfusion was associated with an increased risk of VTE (OR 1.34, CI 1.11-1.62, p = 0.003). However, when individually analyzed, only pRBC transfusion was independently associated with increased VTE risk (OR 1.37, CI 1.24-1.51, p < 0.001).

Conclusions: Trauma patients with TBI undergoing early blood product transfusion had a nearly 50% increased risk of VTE, compared to patients not undergoing transfusion. This risk was primarily attributed to the use of pRBC.

Level of evidence: IV (therapeutic).

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填充红细胞输注：外伤性脑损伤患者血栓形成的催化剂？

本研究探讨了接受和未接受血液制品输血的创伤性脑损伤患者与静脉血栓栓塞（VTE）发生率之间的关系，假设输血会增加VTE的风险。方法：对2017年至2021年创伤质量改善计划（TQIP）进行查询，以确定成人（≥18岁）TBI患者。在到达后4小时内接受任何血液制品输血的TBI患者与未接受输血的患者进行比较。使用双变量分析和多变量逻辑回归对结果进行比较，以确定静脉血栓栓塞的预测因素。结果：451,061例TBI患者中，32,276例（7.2%）患者接受了输血。血栓形成事件在静脉血栓栓塞等输血患者中更为常见（7.6% vs 1.4%, p p p p = 0.003）。然而，当单独分析时，只有pRBC输血与VTE风险增加独立相关（OR 1.37, CI 1.24-1.51, p）。结论：创伤性脑损伤患者接受早期血液制品输血的VTE风险比未接受输血的患者增加近50%。这种风险主要归因于使用pRBC。证据等级：IV（治疗性）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain injury 医学-康复医学

CiteScore

3.50

自引率

5.30%

发文量

148

审稿时长

12 months

期刊介绍： Brain Injury publishes critical information relating to research and clinical practice, adult and pediatric populations. The journal covers a full range of relevant topics relating to clinical, translational, and basic science research. Manuscripts address emergency and acute medical care, acute and post-acute rehabilitation, family and vocational issues, and long-term supports. Coverage includes assessment and interventions for functional, communication, neurological and psychological disorders.