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2018 ; 22
(1
): 100
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The impact of blood type O on mortality of severe trauma patients: a
retrospective observational study
#MMPMID29716619
Takayama W
; Endo A
; Koguchi H
; Sugimoto M
; Murata K
; Otomo Y
Crit Care
2018[May]; 22
(1
): 100
PMID29716619
show ga
BACKGROUND: Recent studies have implicated the differences in the ABO blood
system as a potential risk for various diseases, including hemostatic disorders
and hemorrhage. In this study, we evaluated the impact of the difference in the
ABO blood type on mortality in patients with severe trauma. METHODS: A
retrospective observational study was conducted in two tertiary emergency
critical care medical centers in Japan. Patients with trauma with an Injury
Severity Score (ISS)?>?15 were included. The association between the different
blood types (type O versus other blood types) and the outcomes of all-cause
mortality, cause-specific mortalities (exsanguination, traumatic brain injury,
and others), ventilator-free days (VFD), and total transfusion volume were
evaluated using univariate and multivariate competing-risk regression models.
Moreover, the impact of blood type O on the outcomes was assessed using
regression coefficients in the multivariate analysis adjusted for age, ISS, and
the Revised Trauma Score (RTS). RESULTS: A total of 901 patients were included in
this study. The study population was divided based on the ABO blood type: type O,
284 (32%); type A, 285 (32%); type B, 209 (23%); and type AB, 123 (13%). Blood
type O was associated with high mortality (28% in patients with blood type O
versus 11% in patients with other blood types; p? 0.001). Moreover, this
association was observed in a multivariate model (adjusted odds ratio =?2.86, 95%
confidence interval 1.84-4.46; p? 0.001). The impact of blood type O on
all-cause in-hospital mortality was comparable to 12 increases in the ISS, 1.5
decreases in the RTS, and 26 increases in age. Furthermore, blood type O was
significantly associated with higher cause-specific mortalities and shorter VFD
compared with the other blood types; however, a significant difference was not
observed in the transfusion volume between the two groups. CONCLUSIONS: Blood
type O was significantly associated with high mortality in severe trauma patients
and might have a great impact on outcomes. Further studies elucidating the
mechanism underlying this association are warranted to develop the appropriate
intervention.