AUTHOR=Juárez-Vela Raúl , Quintana-Diaz Manuel , Rodríguez-Calvo Antonio , Santos-Sánchez José Ángel , Gero-Escapa María , Gallego-Curto Elena , Satústegui-Dordá Pedro José , Sánchez-González Juan Luis , Jericó Carlos , Ruiz de Viñaspre-Hernández Regina , Gil-Fernández Guadalupe , García-Erce José Antonio 

TITLE=Profile and characteristics of the adequacy of blood transfusions in Trauma Intensive Care. A cross sectional multicenter study

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1133191

DOI=10.3389/fpubh.2023.1133191

ISSN=2296-2565

ABSTRACT=Major trauma is one of the major health care problems facing modern society, resulting in the deaths of more than five million people worldwide each year, with this number expected to rise to more than eight million by 2020. The Patient Blood Management Program is an integrated and global strategy to provide patient care that aims to assess and address, when possible, the etiology of blood abnormalities rather than transfuse without treating the underlying cause. We aimed to describe the factors that are associated with the clinical decision to transfuse polytraumatized patients admitted to the Intensive Care Unit (ICU). We performed a cross sectional multicenter study of patients admitted to ICUs for trauma in 14 Spanish hospitals from September 2020 to December 2021. A total of 69 patients were treated in the emergency room due to polytrauma, 46 % of them were considered serious in the initial triage. 30 were caused by a fall from considerable height (43.47%), followed by 39 patients admitted due to traffic accidents (56.22%). The location of the trauma was mainly cranioencephalic, followed by thoracic trauma. Of the 69 patients, 25 received a blood transfusion during their ICU stay (36.23%). No significant differences were observed between transfused and non-transfused patients, except for the severity scales, where transfused patients have a higher score on all the scales assessed in the ICU except for the Revised Trauma Score. As we can see,   the incidence of kidney failure was also different between the groups analyzed, reaching 44.00% in transfused patients and 13.64% in the group of patients without blood transfusion, p- value = 0.005. In this sense, 92.00% of the transfusions performed were inadequate according to the criteria of Hb in blood prior to the decision to transfuse (Hb<9). The two groups showed no significant differences in transfused blood components, fresh frozen plasma, platelets, or red blood cells , nor with respect to the drugs administered. Our data support the need to consider clinical practice guidelines regarding blood transfusion and its practices.