Use of leukoreduced blood does not reduce infection, organ failure, or mortality following trauma.
BACKGROUND
Leukoreduced (LR) blood has been demonstrated to reduce morbidity and mortality in high-risk surgical patients, but not in trauma patients. The objective of the present study was to determine the effect of LR blood on morbidity and mortality. We hypothesized that the use of LR blood does not improve outcome in trauma patients.


METHODS
This study was a retrospective cohort analysis of trauma patients transfused at a level 1 Trauma Center from 2001 to 2004. Between 2002 and 2003, LR blood was transfused. Prior to that time and subsequent to it, non-leukoreduced (NLR) blood was transfused. This created two historical comparison groups. Data collected included patient demographics, units of blood transfused, intensive care unit (ICU) and hospital days, ventilator days, injury severity score (ISS), mortality, presence of acute respiratory distress syndrome (ARDS), and infectious complications. A multiple organ dysfunction syndrome (MODS) score was calculated.


RESULTS
The distribution of patients was as follows: 284 patients received only NLR blood, 153 received only LR blood, and 58 received at least one unit of each. The mean ISS was similar (NLR: 26, LR: 24; P > 0.1). No differences were seen between groups in units transfused (6.2 vs. 5.5), number of ICU days (8.2 vs. 9.0), number of hospital days (16.9 vs. 18.6), number of ventilator days (6.1 vs. 5.7), incidence of ARDS (8.3% vs. 8.5%), MODS score (5.5 vs. 5.9), mortality rate (15.1% vs. 15.7%), or infection rate (36% vs. 30%) (P > 0.1).


CONCLUSIONS
This study represents the largest series comparing trauma patients who received either LR or standard blood transfusions. The use of LR blood does not improve outcome in trauma patients.
Englehart
Michael S
MS
Department of Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Road-L223A, Portland, OR 97239, USA.
Cho
S David
SD
Morris
Melanie S
MS
Gee
Arvin C
AC
Riha
Gordon
G
Underwood
Samantha J
SJ
Differding
Jerome A
JA
Luem
Nick D
ND
Wiesberg
Tracy T
TT
Boshkov
Lynn K
LK
Schreiber
Martin A
MA
D000704:Analysis of Variance; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D047589:Leukocyte Reduction Procedures; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology; D012128:Respiratory Distress Syndrome / Q000453:epidemiology; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014947:Wounds and Injuries / Q000401:mortality / Q000601:surgery*