title: Blood utilization in patients with burn injury and association with clinical outcomes (CME).
abstract: BACKGROUND
  Uncontrolled bleeding is an important cause of increased transfusion in burn victims; however, description of blood utilization patterns in the burn population is lacking.
  
  
  METHODS
  We conducted a single-institution, retrospective cohort study to measure blood utilization in 89 consecutive burn patients with 15% to 65% total body surface area (TBSA) burn within 60 days of injury. We also evaluated the relationship of blood product utilization with clinical variables including anticoagulant usage and mortality.
  
  
  RESULTS
  We determined that: 1) the predictors for increased red blood cells (RBCs) and plasma transfusions were high TBSA burn and the use of argatroban anticoagulation (for suspected heparin-induced thrombocytopenia [HIT]); 2) TBSA burn and patient age were independent predictors of mortality, but not RBC or plasma transfusion; and 3) the incidence of symptomatic venous thromboembolic events is not uncommon (11.2%), although HIT is rare (1.1%).
  
  
  CONCLUSIONS
  Despite concerns about adverse correlation between increased number of transfusions and mortality in other clinical settings, we did not find this association in our study. However, we demonstrated that the type and intensity of anticoagulation carries substantial risk for increased RBC as well as plasma usage.
authors.affiliation: Department of Pathology & Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Medicine, Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Biostatistics and North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Surgery, North Carolina Jaycee Burn Center, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Surgery, Division of Trauma and Critical Care Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Rommel P
authors.initials: RP
authors.lastname: Lu
authors.forename: Feng-Chang
authors.initials: FC
authors.lastname: Lin
authors.forename: Shiara M
authors.initials: SM
authors.lastname: Ortiz-Pujols
authors.forename: Sasha D
authors.initials: SD
authors.lastname: Adams
authors.forename: Herbert C
authors.initials: HC
authors.lastname: Whinna
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Cairns
authors.forename: Nigel S
authors.initials: NS
authors.lastname: Key
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D002056:Burns / Q000401:mortality / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000453:epidemiology
chemical_list: D000925:Anticoagulants