M. W. Sauder1,2, T. Wolff1,3, M. C. Spalding1,2, U. B. Pandya1,2 3OhioHealth Doctors Hospital,Department Of Surgery,Columbus, OHIO, USA 1OhioHealth Grant Medical Center,Division Of Trauma And Acute Care Surgery,Columbus, OH, USA 2Ohio University,Heritage College Of Osteopathic Medicine,Dublin, OH, USA
Introduction:
Certain ABO blood types have been identified as risk factors for a variety of disease processes including acute respiratory distress syndrome, acute kidney injury, myocardial infarction, and venous thromboembolism. However, there is a relative paucity of literature regarding the implications of ABO blood type on characteristics and outcomes of traumatically injured patients. A recent study concluded that blood type O was associated with higher mortality in severely injured patients in Japan. The purpose of this study was to determine the association of ABO blood types with outcomes in traumatically injured patients in the United States.
Methods:
This retrospective study evaluated all category 1 and 2 trauma alerts at an urban, Level 1 trauma center from January 1, 2017 through December 31, 2017. Data was obtained from the institutional trauma database and electronic medical record. Patients were excluded if they were pregnant, less than 16 years old, or if blood type data was unavailable. Recorded outcomes included: ABO blood group, mortality, Injury Severity Score (ISS), race, ventilator days, transfusion requirements, massive transfusion protocol, injury type, mechanism of injury, and complications. Data analysis was performed using descriptive statistics including chi-squared and analysis of variance (ANOVA) calculations.
Results:
A total of 3,779 patients met inclusion criteria. The proportions of ABO blood types represented by the patients in our sample data were not significantly different than published national averages. Likewise, no significant differences in age, gender, or ISS were present between blood types. Blood type AB was associated with a statistically significant increase in mortality rate in severely injured (ISS>15) Caucasian patients compared to non-AB blood types (39% vs. 16%; p=0.01). This relationship was not consistent among African-American patients (p=0.37). Neither race exhibited differences in hospital length of stay, intensive care unit length of stay, or ventilator days.
Conclusion:
Blood type AB is associated with increased mortality in severely injured Caucasian patients. This is in contrast to findings in Japanese and African American patients. Though this requires further validation, there is a potential correlation between ABO blood type, ethnicity, and trauma outcomes.
