Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain Injury

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...

Full description

Saved in:
Bibliographic Details
Main Authors: Hasan M. Al-Dorzi, Waleed Al-Humaid, Hani M. Tamim, Samir Haddad, Ahmad Aljabbary, Abdulaziz Arifi, Yaseen M. Arabi
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2015/672639
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850166745636012032
author Hasan M. Al-Dorzi
Waleed Al-Humaid
Hani M. Tamim
Samir Haddad
Ahmad Aljabbary
Abdulaziz Arifi
Yaseen M. Arabi
author_facet Hasan M. Al-Dorzi
Waleed Al-Humaid
Hani M. Tamim
Samir Haddad
Ahmad Aljabbary
Abdulaziz Arifi
Yaseen M. Arabi
author_sort Hasan M. Al-Dorzi
collection DOAJ
description 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.
format Article
id doaj-art-dec9fa9e5b244ad9aafad8ff0b6e051e
institution OA Journals
issn 2090-1305
2090-1313
language English
publishDate 2015-01-01
publisher Wiley
record_format Article
series Critical Care Research and Practice
spelling doaj-art-dec9fa9e5b244ad9aafad8ff0b6e051e2025-08-20T02:21:21ZengWileyCritical Care Research and Practice2090-13052090-13132015-01-01201510.1155/2015/672639672639Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain InjuryHasan M. Al-Dorzi0Waleed Al-Humaid1Hani M. Tamim2Samir Haddad3Ahmad Aljabbary4Abdulaziz Arifi5Yaseen M. Arabi6Intensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi ArabiaCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi ArabiaEpidemiology and Biostatistics, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi ArabiaIntensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi ArabiaIntensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi ArabiaNeurosurgery/Surgery Department, King Abdulaziz Medical City, Riyadh 11426, Saudi ArabiaIntensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi ArabiaRationale. 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.http://dx.doi.org/10.1155/2015/672639
spellingShingle Hasan M. Al-Dorzi
Waleed Al-Humaid
Hani M. Tamim
Samir Haddad
Ahmad Aljabbary
Abdulaziz Arifi
Yaseen M. Arabi
Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain Injury
Critical Care Research and Practice
title Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain Injury
title_full Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain Injury
title_fullStr Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain Injury
title_full_unstemmed Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain Injury
title_short Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain Injury
title_sort anemia and blood transfusion in patients with isolated traumatic brain injury
url http://dx.doi.org/10.1155/2015/672639
work_keys_str_mv AT hasanmaldorzi anemiaandbloodtransfusioninpatientswithisolatedtraumaticbraininjury
AT waleedalhumaid anemiaandbloodtransfusioninpatientswithisolatedtraumaticbraininjury
AT hanimtamim anemiaandbloodtransfusioninpatientswithisolatedtraumaticbraininjury
AT samirhaddad anemiaandbloodtransfusioninpatientswithisolatedtraumaticbraininjury
AT ahmadaljabbary anemiaandbloodtransfusioninpatientswithisolatedtraumaticbraininjury
AT abdulazizarifi anemiaandbloodtransfusioninpatientswithisolatedtraumaticbraininjury
AT yaseenmarabi anemiaandbloodtransfusioninpatientswithisolatedtraumaticbraininjury