Trauma Nova Scotia TNS Spotlight
Impact of Age of Blood on Mortality in Trauma Patients
The impact of the age of stored red blood cells on mortality in patients sustaining traumatic injuries requiring transfusion of blood products is unknown. The objective of this systematic review was to identify and describe the available literature
on the use of older versus newer blood in trauma patient populations.
We searched PubMed, Embase, Lilac and the Cochrane Database for published studies comparing the transfusion of newer versus older red blood cells in adult patients sustaining traumatic injuries. Studies included for review reported on trauma patients receiving transfusions of packed red blood cells, identified the age of stored blood that was transfused and reported patient mortality as an end point. We extracted data using a standardized form and assessed study quality using the Newcastle-Ottawa Scale. The findings of the study are summarized in the infographic.
Seven studies were identified (6780 patients) from 3936 initial search results. Four studies reported that transfusion of older blood was independently associated with increased mortality in trauma patients, while 3 studies did not observe any increase in patient mortality with the use of older versus newer blood. Three studies associated the transfusion of older blood with adverse patient outcomes, including longer stay in the intensive care unit, complicated sepsis, pneumonia and renal dysfunction. Studies varied considerably in design, volumes of blood transfused, and definitions applied for old and new blood.
The impact of the age of stored packed red blood cells on mortality in trauma patients is inconclusive. Future investigations are warranted.
This study was published in the October 2015 issue of the Canadian Journal of Surgery.
Full text of the study is available here.
Posted August 9, 2016