Racial-ethnicity group distributions of blood product use in acute trauma care transfusion.

Background: Recent studies suggest Black patients are transfused less often and at lower hemoglobin levels than White patients. In elective surgery, Black and Non-White patients have greater estimated blood loss and transfusion frequency. We asked whether similar transfusion disparities are observable in acute trauma resuscitation.

Methods: In a single-center retrospective analysis of trauma registry/blood-bank-linked data from a large US trauma center, we identified all acute trauma patients 2011-2022. Our data sources permitted distinction of Race and Ethnicity and therefor binning as Non-White-race/not Hispanic plus any-race/Hispanic or White/not Hispanic. We tallied Injury Severity Scores mild through profound (ISS 1-9, 9-15, 16-25, >25), type (blunt vs. penetrating) and mechanism (firearms, etc.), and associated blood use overall and in the first, first four, and first 24 h, comparing results with chi square, p < .01.

Results: Overall, 50,394 (68.41%) acute trauma patients were classified as White and 23,251 (31.7%) as Other than White. White patients were more likely to receive any blood products (17.8% vs. 11.9%), but, for all measures of urgency/quantity, Non-White patients were transfused more often (respectively, first 4 h, 51.9% vs. 42.1%; ≥3u/first hour, 18.5% vs. 11.0%; ≥10u/24 h, 8.1% vs. 3.8%) (all p < .001). White patients were far more likely to have blunt injury than Non-White patients, (77.2% vs. 42.6%), less likely to have penetrating injury (10.1% vs. 14%) and far less likely to be injured by firearms (30.6% vs. 56.9%) (all p < .001).

Conclusions: At our center, blood use in acute trauma resuscitation was associated with injury severity and mechanism, not race/ethnicity.