Scientific PapersAge of transfused blood is an independent risk factor for postinjury multiple organ failure
Section snippets
Materials and methods
The Colorado Multiple Institutional Review Board approved these studies, and all subjects gave informed consent prior to entry into the study. Patients were eligible for the study if they were aged >17 years, Injury Severity Score (ISS) >15 with at least one extracranial Abbreviated Injury Scale (AIS) >3, evidence of hemorrhagic shock (systolic blood pressure <90 mm Hg), less than 2 hours from their injury, and able to give consent.
Results
Sixty-three patients were identified, 23 of whom developed MOF (MOF+). The mechanism of injury was blunt in 38 patients and penetrating in 25 patients. There was no difference in ISS or transfusion requirement between MOF+ patients and patients who did not develop MOF (MOF−), but MOF+ patients were older (46 ± 4.7 years versus 33 ± 2.3 years, P = 0.03; Table I). Mean age of transfused blood was significantly greater in the MOF+ patients (Figure 1). Similarly, the mean number of units greater
Comments
Transfusion of blood has been identified to be a robust predictor of postinjury MOF.1, 3 Initially, this relationship was felt to reflect a correlation between tissue injury or hemorrhagic shock and blood transfusion requirement. Our subsequent work, however, has shown the number of blood transfusions to be an independent predictor of MOF.3 The recent discovery of the proinflammatory effects of stored blood have provided a possible mechanism for this process. The identification of inflammatory
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