N. Hernandez1, H. Nasef1, A. Elkbuli1 1Orlando Health, Orlando, FL, USA
Introduction: This study aims to evaluate clinical outcomes in geriatric trauma patients with isolated chest or abdominal injuries with or without traumatic brain injury (TBI) receiving whole blood (WB), component (COMP), or whole blood and component therapy (WB+COMP).
Methods: This retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program Participant Use File (ACS-TQIP-PUF) dataset from 2017-2021 evaluated geriatric (age ≥65) trauma patients with moderate-severe isolated chest (AIS chest ≥2) or abdominal (AIS abdomen ≥2) injuries with or without TBI (AIS head ≥2) receiving WB, COMP, or WB+COMP. Outcomes included emergency department (ED) and 24-hour mortality, blood product volume at 4 hours, and intensive-care-unit length of stay (ICU-LOS).
Results: Among non-TBI patients with isolated chest injuries, COMP patients required significantly less plasma (B=-427.548, 95% CI -605.119 – -249.976, p<0.001) and had 48% lower odds of 24-hour mortality compared to WB patients (OR 0.519, 95% CI 0.285-0.946, p=0.032). TBI patients with isolated abdominal injuries receiving COMP required significantly less plasma at 4 hours compared to WB+COMP (B=-844.434, 95% CI -1362.70 – -326.166, p=0.001).
Conclusion: Compared to WB or WB+COMP, COMP therapy significantly reduced transfusion requirements in non-TBI patients. Additionally, COMP therapy was associated with lower 24-hour mortality in geriatric patients with isolated chest injuries. TBI patients with isolated abdominal injuries receiving COMP therapy required significantly less plasma, however there was no significant difference in mortality based on transfusion type. Further research is warranted to explore the potential benefits of COMP therapy on mortality outcomes in TBI patients.