title: Blood transfusions in severe burn patients: Epidemiology and predictive factors.
abstract: BACKGROUND
  Blood is a vital resource commonly used in burn patients; however, description of blood transfusions in severe burns is limited. The purpose of this study was to describe the epidemiology of blood transfusions and determine factors associated with increased transfusion quantity.
  
  
  METHODS
  This is a retrospective study of total 133 patients with >40% total body surface area (TBSA) burns admitted to the burn center of Changhai hospital from January 2008 to December 2013. The study characterized blood transfusions in severe burn patients. Univariate and Multivariate regression analyses were used to evaluate the association of clinical variables with blood transfusions.
  
  
  RESULTS
  The overall transfusion rate was 97.7% (130 of 133). The median amount of total blood (RBC and plasma), RBC and plasma transfusions was 54 units (Interquartile range (IQR), 20-84), 19 units (IQR, 4-37.8) and 28.5 units (IQR, 14.8-51.8), respectively. The number of RBC transfusion in and outside operation room was 7 (0, 14) and 11 (2, 20) units, and the number of plasma was 6 (0.5, 12) and 21 (11.5, 39.3) units. A median of one unit of blood was transfused per TBSA and an average of 4 units per operation was given in the series. The consumption of plasma is higher than that of RBC. On multivariate regression analysis, age, full-thickness TBSA and number of operations were significant independent predictors associated with the number of RBC transfusion, and coagulopathy and ICU length showed a trend toward RBC consumption. Predictors for increased plasma transfusion were female, high full-thickness TBSA burn and more operations.
  
  
  CONCLUSIONS
  Severe burn patients received an ample volume of blood transfusions. Fully understanding of predictors of blood transfusions will allow physicians to better optimize burn patients during hospitalization in an effort to use blood appropriately.
authors: Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: drwuguosheng@sina.cn.
authors: Guosheng
authors: G
authors: Wu
authors: Department of Blood Transfusion, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: zmz_smmu@sina.com.
authors: Mingzhu
authors: M
authors: Zhuang
authors: Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: fxm_smmu@sina.com.
authors: Xiaoming
authors: X
authors: Fan
authors: Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: hxd_smmu@sina.com.
authors: Xudong
authors: X
authors: Hong
authors: Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: wkasmmu@163.com.
authors: Kangan
authors: K
authors: Wang
authors: Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: wh_smmu@sina.com.
authors: He
authors: H
authors: Wang
authors: Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: czl_smmu@sina.com.
authors: Zhengli
authors: Z
authors: Chen
authors: Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: sy_smmu@sina.com.
authors: Yu
authors: Y
authors: Sun
authors: Department of Burn Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China. Electronic address: xiazhaofan_smmu@163.com.
authors: Zhaofan
authors: Z
authors: Xia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001778:Blood Coagulation Disorders / Q000453:epidemiology; D016913:Blood Component Transfusion / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001830:Body Surface Area; D002053:Burn Units; D002056:Burns / Q000453:epidemiology / Q000628:therapy*; D002681:China / Q000453:epidemiology; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010360:Patient Transfer / Q000706:statistics & numerical data; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D014139:Tracheostomy / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D055815:Young Adult
keywords: Blood transfusions; Burn; Epidemiology