title: Correlation between red blood cell transfusion volume and mortality in patients with massive blood transfusion: A large multicenter retrospective study.
abstract: This study aimed to explore the correlation between red blood cell (RBC) transfusion volume and patient mortality in massive blood transfusion. A multicenter retrospective study was carried out on 1,601 surgical inpatients who received massive blood transfusion in 20 large comprehensive hospitals in China. According to RBC transfusion volume and duration, the patients were divided into groups as follows: 0-4, 5-9, 10-14, 15-19, 20-24, 25-29, 30-39 and ≥40 units within 24 or 72 h. Mortality in patients with different RBC transfusion volumes was analyzed. It was found that patient mortality increased with the increase in the volume of RBC transfusion when the total RBC transfusion volume was ≥10 units within 24 or 72 h. Survival analysis revealed significant differences in mortality according to the RBC transfusion volume (χ2=72.857, P<0.001). Logistic regression analysis revealed that RBC transfusion volume is an independent risk factor [odds ratio (OR) = 0.52; confidence interval (CI): 0.43-0.64; P<0.01] for the mortality of patients undergoing a massive blood transfusion. When RBCs were transfused at a volume of 5-9 units within 24 and 72 h, the mortality rate was the lowest, at 3.7 and 2.3% respectively. It is concluded that during massive blood transfusion in surgical inpatients, there is a correlation between RBC transfusion volume within 24 or 72 h and the mortality of the patients. Patient mortality increases with the increase in the volume of RBC transfusion. RBC transfusion volume, the length of stay at hospital and intensive care unit stay constitute the independent risk factors for patient mortality.
authors.affiliation: Department of Transfusion Medicine, The Third Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
authors.forename: Jiang-Cun
authors.initials: JC
authors.lastname: Yang
authors.affiliation: Department of Transfusion Medicine, The Third Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Shaanxi Provincial Center for Clinical Laboratory, The Third Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
authors.forename: Cui-Xiang
authors.initials: CX
authors.lastname: Xu
authors.affiliation: Department of Dermatology, The Third Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
authors.forename: Qian-Li
authors.initials: QL
authors.lastname: Dang
authors.affiliation: Department of Laboratory, The Third Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
authors.forename: Yong-Gang
authors.initials: YG
authors.lastname: Xu
authors.affiliation: Department of Transfusion Medicine, The Third Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
authors.forename: Yao-Jun
authors.initials: YJ
authors.lastname: Song
authors.affiliation: Department of Epidemiology and Health Statistics, Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yan
keywords: massive blood transfusion; mortality; multicenter; red blood cell; retrospective analysis