title: Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in hospital mortality in patients with traumatic injuries.
abstract: BACKGROUND
  In critically ill patients the relationship between the storage age of red blood cells (RBCs) transfused and outcomes are controversial. To determine if duration of RBC storage is associated with adverse outcomes we studied critically ill trauma patients requiring transfusion.
  
  
  METHODS
  This retrospective cohort study included patients with traumatic injuries transfused >or=5 RBC units. Patients transfused >or= 1 unit of RBCs with a maximum storage age of up to 27 days were compared with those transfused 1 or more RBC units with a maximum storage age of >or= 28 days. These study groups were also matched by RBC amount (+/- 1 unit) transfused. Primary outcomes were deep vein thrombosis and in-hospital mortality.
  
  
  RESULTS
  Two hundred and two patients were studied with 101 in both decreased and increased RBC age groups. No differences in admission vital signs, laboratory values, use of DVT prophylaxis, blood products or Injury Severity Scores were measured between study groups. In the decreased compared with increased RBC storage age groups, deep vein thrombosis occurred in 16.7% vs 34.5%, (P = 0.006), and mortality was 13.9% vs 26.7%, (P = 0.02), respectively. Patients transfused RBCs of increased storage age had an independent association with mortality, OR (95% CI), 4.0 (1.34 - 11.61), (P = 0.01), and had an increased incidence of death from multi-organ failure compared with the decreased RBC age group, 16% vs 7%, respectively, (P = 0.037).
  
  
  CONCLUSIONS
  In trauma patients transfused >/=5 units of RBCs, transfusion of RBCs >or= 28 days of storage may be associated with deep vein thrombosis and death from multi-organ failure.
authors.affiliation: Department of Pediatrics, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, USA. phil_spinella@yahoo.com
authors.forename: Philip C
authors.initials: PC
authors.lastname: Spinella
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Carroll
authors.forename: Ilene
authors.initials: I
authors.lastname: Staff
authors.forename: Ronald
authors.initials: R
authors.lastname: Gross
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Mc Quay
authors.forename: Lauren
authors.initials: L
authors.lastname: Keibel
authors.forename: Charles E
authors.initials: CE
authors.lastname: Wade
authors.forename: John B
authors.initials: JB
authors.lastname: Holcomb
mesh_terms: D000328:Adult; D001793:Blood Preservation; D015331:Cohort Studies; D003237:Connecticut / Q000453:epidemiology; D000075202:Contraindications; D016638:Critical Illness; D017707:Erythrocyte Transfusion; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D020246:Venous Thrombosis / Q000209:etiology* / Q000401:mortality*; D014947:Wounds and Injuries / Q000097:blood*