Inhalation Injury Does Not Influence the Amount of Blood Transfused to Major Burn Patients: A Secondary Analysis from the Transfusion Requirement in Burn Care Evaluation Study

Robert Cartotto, Sandra L. Taylor, James H. Holmes, Brett Arnoldo, Michael Peck, Amalia Cochran, Booker T.King Col, Dhaval Bhavsar, Edward E. Tredget, Francois Stapelberg, Bruce Friedman, David Mozingo, David Greenhalgh, Bradley H. Pollock, Tina L. Palmieri

Research output: Contribution to journalArticle

Abstract

Patients with major burn injuries typically require numerous blood transfusions. It is not known if an inhalation injury (INHI) directly influences the need for blood transfusion. The purpose of this study was to determine whether INHI increases the amount of blood transfused to major burn patients. A secondary analysis from the Transfusion Requirement in Burn Care Evaluation (TRIBE) study was conducted. Patients with INHI were compared with patients without INHI. The number of red blood cell (RBC) transfusions per day (RBC per day) between INHI and No INHI was analyzed with a multivariable regression. Patients with INHI (n = 78) had significantly larger burns (P = .0004), larger full-thickness burns (P = .0007), greater admission APACHE score (P < .0001), higher admission multiple organ dysfunction scores (P < .0001), and were transfused more RBC per day (P = .009) than No INHI patients (n = 267). In the multivariable regression analysis, RBC per day was significantly associated with the %TBSA burn (P < .0001), age of the patient (P = .004), the need for more than 1 day of mechanical ventilation (P < .0001), the occurrence of at least one blood stream infection (BSI; P = .044), and being assigned to the liberal transfusion arm of TRIBE (P < .001) but not the presence of INHI (P = .056). The null hypothesis that INHI exerts no influence on the amount of blood transfused could not be rejected. Larger burn size, advanced patient age, mechanical ventilation, and BSIs are important determinants of the blood transfusion rate in major burn patients.

Original languageEnglish (US)
Pages (from-to)757-762
Number of pages6
JournalJournal of burn care & research : official publication of the American Burn Association
Volume40
Issue number6
DOIs
StatePublished - Oct 16 2019

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Inhalation
Wounds and Injuries
Blood Transfusion
Burns
Artificial Respiration
Erythrocytes
Organ Dysfunction Scores
Erythrocyte Transfusion
APACHE
Regression Analysis
Infection

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Rehabilitation

Cite this

Inhalation Injury Does Not Influence the Amount of Blood Transfused to Major Burn Patients : A Secondary Analysis from the Transfusion Requirement in Burn Care Evaluation Study. / Cartotto, Robert; Taylor, Sandra L.; Holmes, James H.; Arnoldo, Brett; Peck, Michael; Cochran, Amalia; Col, Booker T.King; Bhavsar, Dhaval; Tredget, Edward E.; Stapelberg, Francois; Friedman, Bruce; Mozingo, David; Greenhalgh, David; Pollock, Bradley H.; Palmieri, Tina L.

In: Journal of burn care & research : official publication of the American Burn Association, Vol. 40, No. 6, 16.10.2019, p. 757-762.

Research output: Contribution to journalArticle

Cartotto, R, Taylor, SL, Holmes, JH, Arnoldo, B, Peck, M, Cochran, A, Col, BTK, Bhavsar, D, Tredget, EE, Stapelberg, F, Friedman, B, Mozingo, D, Greenhalgh, D, Pollock, BH & Palmieri, TL 2019, 'Inhalation Injury Does Not Influence the Amount of Blood Transfused to Major Burn Patients: A Secondary Analysis from the Transfusion Requirement in Burn Care Evaluation Study', Journal of burn care & research : official publication of the American Burn Association, vol. 40, no. 6, pp. 757-762. https://doi.org/10.1093/jbcr/irz129
Cartotto, Robert ; Taylor, Sandra L. ; Holmes, James H. ; Arnoldo, Brett ; Peck, Michael ; Cochran, Amalia ; Col, Booker T.King ; Bhavsar, Dhaval ; Tredget, Edward E. ; Stapelberg, Francois ; Friedman, Bruce ; Mozingo, David ; Greenhalgh, David ; Pollock, Bradley H. ; Palmieri, Tina L. / Inhalation Injury Does Not Influence the Amount of Blood Transfused to Major Burn Patients : A Secondary Analysis from the Transfusion Requirement in Burn Care Evaluation Study. In: Journal of burn care & research : official publication of the American Burn Association. 2019 ; Vol. 40, No. 6. pp. 757-762.
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AU - Cartotto, Robert

AU - Taylor, Sandra L.

AU - Holmes, James H.

AU - Arnoldo, Brett

AU - Peck, Michael

AU - Cochran, Amalia

AU - Col, Booker T.King

AU - Bhavsar, Dhaval

AU - Tredget, Edward E.

AU - Stapelberg, Francois

AU - Friedman, Bruce

AU - Mozingo, David

AU - Greenhalgh, David

AU - Pollock, Bradley H.

AU - Palmieri, Tina L.

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N2 - Patients with major burn injuries typically require numerous blood transfusions. It is not known if an inhalation injury (INHI) directly influences the need for blood transfusion. The purpose of this study was to determine whether INHI increases the amount of blood transfused to major burn patients. A secondary analysis from the Transfusion Requirement in Burn Care Evaluation (TRIBE) study was conducted. Patients with INHI were compared with patients without INHI. The number of red blood cell (RBC) transfusions per day (RBC per day) between INHI and No INHI was analyzed with a multivariable regression. Patients with INHI (n = 78) had significantly larger burns (P = .0004), larger full-thickness burns (P = .0007), greater admission APACHE score (P < .0001), higher admission multiple organ dysfunction scores (P < .0001), and were transfused more RBC per day (P = .009) than No INHI patients (n = 267). In the multivariable regression analysis, RBC per day was significantly associated with the %TBSA burn (P < .0001), age of the patient (P = .004), the need for more than 1 day of mechanical ventilation (P < .0001), the occurrence of at least one blood stream infection (BSI; P = .044), and being assigned to the liberal transfusion arm of TRIBE (P < .001) but not the presence of INHI (P = .056). The null hypothesis that INHI exerts no influence on the amount of blood transfused could not be rejected. Larger burn size, advanced patient age, mechanical ventilation, and BSIs are important determinants of the blood transfusion rate in major burn patients.

AB - Patients with major burn injuries typically require numerous blood transfusions. It is not known if an inhalation injury (INHI) directly influences the need for blood transfusion. The purpose of this study was to determine whether INHI increases the amount of blood transfused to major burn patients. A secondary analysis from the Transfusion Requirement in Burn Care Evaluation (TRIBE) study was conducted. Patients with INHI were compared with patients without INHI. The number of red blood cell (RBC) transfusions per day (RBC per day) between INHI and No INHI was analyzed with a multivariable regression. Patients with INHI (n = 78) had significantly larger burns (P = .0004), larger full-thickness burns (P = .0007), greater admission APACHE score (P < .0001), higher admission multiple organ dysfunction scores (P < .0001), and were transfused more RBC per day (P = .009) than No INHI patients (n = 267). In the multivariable regression analysis, RBC per day was significantly associated with the %TBSA burn (P < .0001), age of the patient (P = .004), the need for more than 1 day of mechanical ventilation (P < .0001), the occurrence of at least one blood stream infection (BSI; P = .044), and being assigned to the liberal transfusion arm of TRIBE (P < .001) but not the presence of INHI (P = .056). The null hypothesis that INHI exerts no influence on the amount of blood transfused could not be rejected. Larger burn size, advanced patient age, mechanical ventilation, and BSIs are important determinants of the blood transfusion rate in major burn patients.

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