title: Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain Injury.
abstract: Rationale. By reducing cerebral oxygen delivery, anemia may aggravate traumatic brain injury (TBI) secondary insult. This study evaluated the impact of anemia and blood transfusion on TBI outcomes. Methods. This was a retrospective cohort study of adult patients with isolated TBI at a tertiary-care intensive care unit from 1/1/2000 to 31/12/2011. Daily hemoglobin level and packed red blood cell (PRBC) transfusion were recorded. Patients with hemoglobin < 10 g/dL during ICU stay (anemic group) were compared with other patients. Results. Anemia was present on admission in two (2%) patients and developed in 48% during the first week with hemoglobin < 7 g/dL occurring in 3.0%. Anemic patients had higher admission Injury Severity Score and underwent more craniotomy (50% versus 13%, p < 0.001). Forty percent of them received PRBC transfusion (2.8 ± 1.5 units per patient, median pretransfusion hemoglobin = 8.8 g/dL). Higher hospital mortality was associated with anemia (25% versus 6% for nonanemic patients, p = 0.01) and PRBC transfusion (38% versus 9% for nontransfused patients, p = 0.003). On multivariate analysis, only PRBC transfusion independently predicted hospital mortality (odds ratio: 6.8; 95% confidence interval: 1.1-42.3). Conclusions. Anemia occurred frequently after isolated TBI, but only PRBC transfusion independently predicted mortality.
authors.affiliation: Intensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia ; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia.
authors.forename: Hasan M
authors.initials: HM
authors.lastname: Al-Dorzi
authors.affiliation: College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia.
authors.forename: Waleed
authors.initials: W
authors.lastname: Al-Humaid
authors.affiliation: Epidemiology and Biostatistics, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia ; Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon.
authors.forename: Hani M
authors.initials: HM
authors.lastname: Tamim
authors.affiliation: Intensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia.
authors.forename: Samir
authors.initials: S
authors.lastname: Haddad
authors.affiliation: Intensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia ; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Aljabbary
authors.affiliation: Neurosurgery/Surgery Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia.
authors.forename: Abdulaziz
authors.initials: A
authors.lastname: Arifi
authors.affiliation: Intensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia ; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia.
authors.forename: Yaseen M
authors.initials: YM
authors.lastname: Arabi