Age of transfused blood in critically ill adult trauma patients: a prespecified nested analysis of the Age of Blood Evaluation randomized trial

on behalf of the ABLE Investigators and the Canadian Critical Care Trials Group

doi:10.1111/trf.14640

Age of transfused blood in critically ill adult trauma patients: a prespecified nested analysis of the Age of Blood Evaluation randomized trial

on behalf of the ABLE Investigators and the Canadian Critical Care Trials Group

Medicine

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

9 Citas (Scopus)

Resumen

BACKGROUND: Blood transfusion is common in the resuscitation of patients with traumatic injury. However, the clinical impact of the length of storage of transfused blood is unclear in this population. STUDY DESIGN AND METHODS: We undertook a prespecified nested analysis of 372 trauma victims of the 2510 critically ill patients from 64 centers treated as part of the Age of Blood Evaluation (ABLE) randomized controlled trial. Patients were randomized according to their trauma status to receive either a transfusion of fresh blood stored not more than 7 days or standard-issue blood. Our primary outcome was 90-day all-cause mortality. RESULTS: Overall, 186 trauma patients received fresh blood and 186 received standard-issue blood. Adherence to transfusion protocol was 94% (915/971) for all fresh blood transfused and 100% (753/753) for all standard-issue blood transfused. Mean ± SD blood storage duration was 5.6 ± 3.8 days in the fresh group and 22.7 ± 8.4 days in the standard-issue group (p < 0.001). Ninety-day mortality in the fresh group was 21% (38/185), compared to 16% (29/184) in the standard-issue group, with an unadjusted absolute risk difference of 5% (95% confidence interval [CI], –3.1 to 12.6) and an adjusted absolute risk difference of 2% (95% CI, –3.5 to 6.8). CONCLUSION: In critically ill trauma patients, transfusion of fresh blood did not decrease 90-day mortality or secondary outcomes, a finding similar to the overall population of the ABLE trial.

Idioma original	English
Páginas (desde-hasta)	1846-1854
Número de páginas	9
Publicación	Transfusion
Volumen	58
N.º	8
DOI	https://doi.org/10.1111/trf.14640
Estado	Published - ago. 2018

Nota bibliográfica

Funding Information:
The authors are grateful to the patients, their family members, the site investigators, the research coordinators, and the blood transfusion personnel who participated in the ABLE trial. We are also thankful to the Canadian Critical Care Trials Group for their support of this study.

Funding Information:
Funding for this study was provided by peer-reviewed grants from the Canadian Institutes of Health Research (177453); Fonds de Recherche du Québec-Santé (24460); the National Institute for Health Research Evaluation, Trials, and Studies Coordinating Centre Health Technology Assessment Program; the French Ministry of Health Programme Hospi-talier de Recherche Clinique (12.07, 2011); Établissement Franc¸ais du Sang; and Sanquin Blood Supply. RSG was supported by a Clinician Scientist Award from Dalhousie University Faculty of Medicine. ATT was supported by an Ottawa Hospital Department of Medicine research award. AFT is the Canada Research Chair in Critical Care Neurology and Trauma. The funding bodies did not have any roles in study design, data collection, data analysis, data interpretation, or manuscript preparation.

Publisher Copyright:
© 2018 AABB

ASJC Scopus Subject Areas

Immunology and Allergy
Immunology
Hematology

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Age of transfused blood in critically ill adult trauma patients: a prespecified nested analysis of the Age of Blood Evaluation randomized trial. / on behalf of the ABLE Investigators and the Canadian Critical Care Trials Group.
En: Transfusion, Vol. 58, N.º 8, 08.2018, p. 1846-1854.

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

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title = "Age of transfused blood in critically ill adult trauma patients: a prespecified nested analysis of the Age of Blood Evaluation randomized trial",

abstract = "BACKGROUND: Blood transfusion is common in the resuscitation of patients with traumatic injury. However, the clinical impact of the length of storage of transfused blood is unclear in this population. STUDY DESIGN AND METHODS: We undertook a prespecified nested analysis of 372 trauma victims of the 2510 critically ill patients from 64 centers treated as part of the Age of Blood Evaluation (ABLE) randomized controlled trial. Patients were randomized according to their trauma status to receive either a transfusion of fresh blood stored not more than 7 days or standard-issue blood. Our primary outcome was 90-day all-cause mortality. RESULTS: Overall, 186 trauma patients received fresh blood and 186 received standard-issue blood. Adherence to transfusion protocol was 94% (915/971) for all fresh blood transfused and 100% (753/753) for all standard-issue blood transfused. Mean ± SD blood storage duration was 5.6 ± 3.8 days in the fresh group and 22.7 ± 8.4 days in the standard-issue group (p < 0.001). Ninety-day mortality in the fresh group was 21% (38/185), compared to 16% (29/184) in the standard-issue group, with an unadjusted absolute risk difference of 5% (95% confidence interval [CI], –3.1 to 12.6) and an adjusted absolute risk difference of 2% (95% CI, –3.5 to 6.8). CONCLUSION: In critically ill trauma patients, transfusion of fresh blood did not decrease 90-day mortality or secondary outcomes, a finding similar to the overall population of the ABLE trial.",

author = "{on behalf of the ABLE Investigators and the Canadian Critical Care Trials Group} and Green, {Robert S.} and Mete Erdogan and Jacques Lacroix and H{\'e}bert, {Paul C.} and Tinmouth, {Alan T.} and Elham Sabri and Tinghua Zhang and Fergusson, {Dean A.} and Turgeon, {Alexis F.}",

note = "Funding Information: The authors are grateful to the patients, their family members, the site investigators, the research coordinators, and the blood transfusion personnel who participated in the ABLE trial. We are also thankful to the Canadian Critical Care Trials Group for their support of this study. Funding Information: Funding for this study was provided by peer-reviewed grants from the Canadian Institutes of Health Research (177453); Fonds de Recherche du Qu{\'e}bec-Sant{\'e} (24460); the National Institute for Health Research Evaluation, Trials, and Studies Coordinating Centre Health Technology Assessment Program; the French Ministry of Health Programme Hospi-talier de Recherche Clinique (12.07, 2011); {\'E}tablissement Franc¸ais du Sang; and Sanquin Blood Supply. RSG was supported by a Clinician Scientist Award from Dalhousie University Faculty of Medicine. ATT was supported by an Ottawa Hospital Department of Medicine research award. AFT is the Canada Research Chair in Critical Care Neurology and Trauma. The funding bodies did not have any roles in study design, data collection, data analysis, data interpretation, or manuscript preparation. Publisher Copyright: {\textcopyright} 2018 AABB",

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T2 - a prespecified nested analysis of the Age of Blood Evaluation randomized trial

AU - on behalf of the ABLE Investigators and the Canadian Critical Care Trials Group

AU - Green, Robert S.

AU - Erdogan, Mete

AU - Lacroix, Jacques

AU - Hébert, Paul C.

AU - Tinmouth, Alan T.

AU - Sabri, Elham

AU - Zhang, Tinghua

AU - Fergusson, Dean A.

AU - Turgeon, Alexis F.

N1 - Funding Information: The authors are grateful to the patients, their family members, the site investigators, the research coordinators, and the blood transfusion personnel who participated in the ABLE trial. We are also thankful to the Canadian Critical Care Trials Group for their support of this study. Funding Information: Funding for this study was provided by peer-reviewed grants from the Canadian Institutes of Health Research (177453); Fonds de Recherche du Québec-Santé (24460); the National Institute for Health Research Evaluation, Trials, and Studies Coordinating Centre Health Technology Assessment Program; the French Ministry of Health Programme Hospi-talier de Recherche Clinique (12.07, 2011); Établissement Franc¸ais du Sang; and Sanquin Blood Supply. RSG was supported by a Clinician Scientist Award from Dalhousie University Faculty of Medicine. ATT was supported by an Ottawa Hospital Department of Medicine research award. AFT is the Canada Research Chair in Critical Care Neurology and Trauma. The funding bodies did not have any roles in study design, data collection, data analysis, data interpretation, or manuscript preparation. Publisher Copyright: © 2018 AABB

PY - 2018/8

Y1 - 2018/8

N2 - BACKGROUND: Blood transfusion is common in the resuscitation of patients with traumatic injury. However, the clinical impact of the length of storage of transfused blood is unclear in this population. STUDY DESIGN AND METHODS: We undertook a prespecified nested analysis of 372 trauma victims of the 2510 critically ill patients from 64 centers treated as part of the Age of Blood Evaluation (ABLE) randomized controlled trial. Patients were randomized according to their trauma status to receive either a transfusion of fresh blood stored not more than 7 days or standard-issue blood. Our primary outcome was 90-day all-cause mortality. RESULTS: Overall, 186 trauma patients received fresh blood and 186 received standard-issue blood. Adherence to transfusion protocol was 94% (915/971) for all fresh blood transfused and 100% (753/753) for all standard-issue blood transfused. Mean ± SD blood storage duration was 5.6 ± 3.8 days in the fresh group and 22.7 ± 8.4 days in the standard-issue group (p < 0.001). Ninety-day mortality in the fresh group was 21% (38/185), compared to 16% (29/184) in the standard-issue group, with an unadjusted absolute risk difference of 5% (95% confidence interval [CI], –3.1 to 12.6) and an adjusted absolute risk difference of 2% (95% CI, –3.5 to 6.8). CONCLUSION: In critically ill trauma patients, transfusion of fresh blood did not decrease 90-day mortality or secondary outcomes, a finding similar to the overall population of the ABLE trial.

AB - BACKGROUND: Blood transfusion is common in the resuscitation of patients with traumatic injury. However, the clinical impact of the length of storage of transfused blood is unclear in this population. STUDY DESIGN AND METHODS: We undertook a prespecified nested analysis of 372 trauma victims of the 2510 critically ill patients from 64 centers treated as part of the Age of Blood Evaluation (ABLE) randomized controlled trial. Patients were randomized according to their trauma status to receive either a transfusion of fresh blood stored not more than 7 days or standard-issue blood. Our primary outcome was 90-day all-cause mortality. RESULTS: Overall, 186 trauma patients received fresh blood and 186 received standard-issue blood. Adherence to transfusion protocol was 94% (915/971) for all fresh blood transfused and 100% (753/753) for all standard-issue blood transfused. Mean ± SD blood storage duration was 5.6 ± 3.8 days in the fresh group and 22.7 ± 8.4 days in the standard-issue group (p < 0.001). Ninety-day mortality in the fresh group was 21% (38/185), compared to 16% (29/184) in the standard-issue group, with an unadjusted absolute risk difference of 5% (95% confidence interval [CI], –3.1 to 12.6) and an adjusted absolute risk difference of 2% (95% CI, –3.5 to 6.8). CONCLUSION: In critically ill trauma patients, transfusion of fresh blood did not decrease 90-day mortality or secondary outcomes, a finding similar to the overall population of the ABLE trial.

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Age of transfused blood in critically ill adult trauma patients: a prespecified nested analysis of the Age of Blood Evaluation randomized trial

Resumen

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ASJC Scopus Subject Areas

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