title: Injury severity, sex, and transfusion volume, but not transfusion ratio, predict inflammatory complications after traumatic injury.
abstract: BACKGROUND
  Blood component (packed red blood cells [PRBC], fresh frozen plasma [FFP], platelets [PLT]) ratios transfused in a 1:1:1 fashion are associated with survival after trauma; the relationship among blood component ratios and inflammatory complications after trauma is not fully understood.
  
  
  OBJECTIVE
  To evaluate the relationship among blood component ratios (1:1 vs other for PRBC:FFP and PRBC:PLT) and inflammatory complications (primary outcome) in patients with major trauma.
  
  
  METHODS
  Secondary analysis of a multi-institution database (N = 1538). Survival methods were used to determine the relationship among blood component ratios and inflammatory complications.
  
  
  RESULTS
  Patients were primarily male (68%), Caucasians (89%), aged 39 ± 14 years, involved in a motor vehicle collision (53%). Eighty-six percent of patients developed an inflammatory complication; 76% developed organ failure, 27% ventilator-associated pneumonia, and 24% acute respiratory distress syndrome. Injury severity, sex, and total PRBC transfusion volume, not blood component ratio, predicted inflammatory complications.
  
  
  CONCLUSIONS
  Increased understanding of factors associated with inflammation after trauma and PRBC transfusion is needed.
authors.affiliation: University of Alabama at Birmingham School of Nursing, NB 543, 1720 2nd Ave S, Birmingham, AL 35294-1210, United States. Electronic address: arjones3@uab.edu.
authors.forename: Allison R
authors.initials: AR
authors.lastname: Jones
authors.affiliation: University of Kentucky College of Public Health, 111 Washington Ave, Lexington, KY 40536, United States.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Bush
authors.affiliation: University of Kentucky College of Nursing, 751 Rose St, Lexington, KY 40536-0232, United States.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Frazier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016913:Blood Component Transfusion; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D055815:Young Adult
keywords: Blood transfusion; Erythrocyte transfusion; Hemorrhage; Inflammation; Trauma