Analysis of anatomical localization and severity of injury in patients with blood transfusion in urban terrain hospital.

Background: Blood loss is the most significant cause of mortality in trauma cases. In injured patients, rapid evaluation and appropriate transfusion is lifesaving. The present study aims to analyze the blood/blood products requirement based on available data and find any associations between the transfusion requirements and injury severity scores (ISS) and anatomical locations of injuries of transfused patients.

Methods: Between 30 July 2014 and 30 July 2016, casualties admitted to the urban terrain hospital (UTH) and transfused at least one unit of red blood cell (RBC) were included. UTH Transfusion Record Notebook data included patients' age, mechanism and anatomical location(s) of the injury, admission hemoglobin (g/dL) level, injury severity score (ISS), transfused units of erythrocyte suspension (ES), warm fresh whole blood (WFWB), fresh frozen plasma (FFP), and massive transfusion (MT) rate.

Results: In this study, all patients were male; the mean age was 28.7±7.8 years. Overall, 59 of 579 (10%) patients were transfused 458 units of RBC (ES+WFWB). Torso (thorax ± abdomen) injury was present in 61% of the casualties who underwent transfusion, and 93% of these patients underwent massive transfusion. In 71% of patients, the ISS was >15, and there was statistically significant high blood/blood products use and MT rate in these patients, respectively (p=0.021, p=0.006).

Conclusion: Anatomical location of injuries and ISS are valuable in the rapid determining of MT and survival rates of casualties. Especially in torso injuries, bleeding control is difficult and transfusion requirement and mortality rates are high. This study presents the trauma of urban terrain conflict-related transfusion data from a UTH.