gms | German Medical Science

Background: Allogeneic blood transfusions are common in the treatment of severely burned patients as surgery may lead to major blood loss. However, transfusions are associated with a number of adverse events. Therefore, the purpose of our study was to investigate the impact of allogeneic blood transfusions on clinical outcomes in severely burned patients.

Methods: This retrospective study included all adult patients admitted to the burn center of the University Hospital Zurich between January 2004 and December 2014, with burn injuries greater than 10% of total body surface area and requiring both surgical and intensive care treatment. Simple and multivariable logistic and linear regression models, adjusted for injury severity and confounders, were applied.

Results: 413 patients met inclusion criteria of which 212 patients (51%) required allogenic blood products. After adjustment for injury severity and confounders, red blood cell transfusion was independently associated with wound infection (OR 13.5, 95% CI 1.7 to 107, p=0.014), sepsis (OR 8.3, 4.2 to 16.3; p<0.001), pneumonia (OR 4.7, 2.2 to 10.0; p<0.001), thrombosis (OR 3.0, 1.2 to 7.4; p=0.015), central line infection (OR 34.7, 4.6 to 260; p=0.001) and a longer ICU and hospital stay (difference 17.7, 95% CI 12.1 to 23.4, p<0.001 and 22.0, 15.8 to 28.2, p<0.001, respectively). Fresh frozen plasma transfusion was independently associated with a longer ICU and hospital stay (difference 13.7, 95% CI 5.5 to 21.8, p=0.001 and 13.5, 4.6 to 22.5, p=0.003, respectively). Platelet transfusion was independently associated with systemic inflammatory response syndrome (OR 4.5, 1.3 to 15.5; p=0.018) and mortality (OR 5.8, 2.1 to 16.0; p=0.001).

Conclusion: Transfusion of allogeneic blood products is associated with an increased infection rate and thromboembolic morbidity and a longer hospital stay in severely burned patients.