title: Jack A. Barney resident paper award: blood transfusions increase complications in moderately injured patients.
abstract: BACKGROUND
  Previous assessments linked transfusions in trauma to increased respiratory and infectious complications. However, these studies included patients with severe trauma, brisk hemorrhage, and shock. Thus, the potentially harmful impact of transfusion was difficult to determine.
  
  
  METHODS
  A retrospective review of all trauma patients with an injury severity score (ISS) of 9 to 14 admitted to a Level 1 Trauma Center over a 5-year period was performed. Patients were stratified by transfusion history and injury severity.
  
  
  RESULTS
  Records of 2,332 patients were reviewed; 208 (8.9%) received at least 1 packed red blood cell transfusion. The incidence of complications was significantly higher in patients receiving transfusions (42.3% vs 9.0%; P < .001), and transfusion was a significant independent predictor of the development of a complication (odds ratio, 5.85; P < .001). Further, the association of transfusion with complications was dose-dependent. Transfusion was associated with a significantly increased hospital length of stay (10.6 vs 3.9 days; P < .0001).
  
  
  CONCLUSIONS
  Moderately injured trauma patients receiving transfusions suffered significantly more complications. Indications for transfusion in this population should be reassessed carefully.
authors.affiliation: Department of Surgery, The University of Kansas School of Medicine, Wichita, KS 67214, USA.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Kopriva
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Helmer
authors.forename: R Stephen
authors.initials: RS
authors.lastname: Smith
mesh_terms: D000328:Adult; D001794:Blood Pressure; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D006454:Hemoglobins; D006801:Humans; D007108:Immune Tolerance; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D012307:Risk Factors; D014947:Wounds and Injuries / Q000150:complications* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy
chemical_list: D006454:Hemoglobins