86.17 Variation of Packed Red Blood Cell Unit Age in a Massively Transfused Trauma Patient Population

Posted on January 26, 2017

A. R. Jones1, R. L. Griffin2, R. Patel6, H. E. Wang5, M. B. Marques6, J. Pittet4, J. Kerby3  6University Of Alabama at Birmingham,Department Of Pathology,Birmingham, Alabama, USA 1University Of Alabama at Birmingham,School Of Nursing,Birmingham, Alabama, USA 2University Of Alabama at Birmingham,School Of Public Health,Birmingham, Alabama, USA 3University Of Alabama at Birmingham,Acute Care Surgery,Birmingham, Alabama, USA 4University Of Alabama at Birmingham,Anesthesiology & Perioperative Medicine,Birmingham, Alabama, USA 5University Of Alabama at Birmingham,Emergency Medicine,Birmingham, Alabama, USA

Introduction:  Transfusion of stored older (≥ 21 days) packed red blood cells (PRBCs) has been associated with increased trauma morbidity and mortality. The age of PRBCs used in trauma patients is unknown. We sought to determine trauma center variations in the age of PRBCs used in massive transfusion.

Methods:  We used data from the Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) trial, a 12-center randomized trial comparing 1:1:1 with 1:1:2 plasma: platelet: PRBC transfusion ratios in massively transfused (≥ 10 units PRBCs) trauma patients. We categorized PRBC age as: <10, 10-14, 15-20, or ≥ 21 days. We compared the transfused PRBC age distribution between trauma centers using the Kruskal-Wallis test. We examined the correlation between center-level PRBC age using Spearman’s correlation.

Results: The study centers transfused a total of 19,655 PRBC units (median 1,434 units [IQR 946, 1,974] per center). Median PRBC age was 9 days (IQR 2-22). Median PRBC age varied by trauma center (5 days [IQR 1-16] to 21 days [IQR 3-30]) (p < 0.0001). The proportion of PRBC age varied across trauma centers; < 10 days 43-66%, 10-14 days 2-20%, 15-20 days 7-19%, ≥ 21 days 5-47% (Figure 1). There were strong negative correlations between the trauma center proportions of ≥ 21 day and < 10 day PRBCs (r = -0.89, p = 0.0001), and ≥ 21 day and 10-14 days PRBCs (r = -0.96, p < 0.0001).

Conclusion: Among trauma centers participating in the PROPPR trial, there was a wide variation in the age of transfused PRBCs.