Anemia and blood transfusion in trauma patients admitted to the intensive care unit.
BACKGROUND
Anemia is a common occurrence in the intensive care unit (ICU). Although resuscitation, including the use of blood, is a mainstay of early treatment of trauma victims, the safety and efficacy of red blood cell (RBC) transfusion has come under scrutiny recently. The issue of blood use in critically injured patients requires evaluation.


METHODS
This was a post hoc analysis of a subset of trauma patients (> or =18 years in age) from a prospective, multicenter, observational, cohort study in the United States. Patients were enrolled within 48 hours after ICU admission and followed for up to 30 days, or until hospital discharge or death.


RESULTS
Five hundred seventy-six patients from 111 ICUs in 100 hospitals were enrolled between August 2000 and April 2001. At baseline, mean age was 44.1 +/- 20.2 years, 73.6% were men, and mean APACHE II score was 16.9 +/- 8.2. Mean baseline hemoglobin was 11.1 +/- 2.4 g/dL and patients remained anemic throughout the study either with or without transfusion; 55.4% of patients were transfused (mean, 5.8 +/- 5.5 units) during the ICU stay and 43.8% of patients had an ICU length of stay > or = 7 days. Mean pretransfusion hemoglobin was 8.9 +/- 1.8 g/dL. Mean age of RBCs transfused was 20.1 +/- 11.4 days. As compared with the full study population, patients in the trauma subset were more likely to be transfused and received an average of 1 additional unit of blood.


CONCLUSIONS
Anemia is common in critically injured trauma patients and persists throughout the duration of critical illness. These patients receive a large number of RBC transfusions during their ICU course with aged blood.
Shapiro
Marc J
MJ
Department of Surgery, Saint Louis University, Missouri 63110-0250, USA. shapirom@slu.edu
Gettinger
Andrew
A
Corwin
Howard L
HL
Napolitano
Lena
L
Levy
Mitchell
M
Abraham
Edward
E
Fink
Mitchell P
MP
MacIntyre
Neil
N
Pearl
Ronald G
RG
Shabot
M Michael
MM
D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000209:etiology* / Q000628:therapy*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012189:Retrospective Studies; D065227:Transfusion Reaction; D014947:Wounds and Injuries / Q000097:blood / Q000150:complications* / Q000628:therapy*
D006454:Hemoglobins