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Blood utilization and mortality in victims of gun violence.

Publication ,  Journal Article
DeMario, VM; Sikorski, RA; Efron, DT; Serbanescu, MA; Buchanan, RM; Wang, EJ; Visagie, M; Gehrie, EA; Manukyan, MC; Noll, K; Ken Lee, KH ...
Published in: Transfusion
October 2018

BACKGROUND: Blood transfusion can be lifesaving for patients with hemorrhage; however, transfusion requirements for victims of gun violence are poorly understood. STUDY DESIGN AND METHODS: In an urban, Level 1 trauma center, 23,422 trauma patients were analyzed in a retrospective cohort study. Patients with gunshot wounds (GSWs) (n = 2,672; 11.4% of trauma patients) were compared to those with non-GSW traumatic injuries from 2005 to 2017, to assess blood utilization. RESULTS: The GSW cohort was approximately five times more likely to require transfusion (538 of 2672 [20.1%] vs. 798 of 20,750 [3.9%]; p < 0.0001), and the number of blood component units transfused per patient was approximately 10 times greater (3.3 ± 13.5 vs. 0.31 ± 3.8 units/patient; p < 0.0001), compared to the non-GSW cohort. The risk-adjusted likelihood of requiring high-dose transfusion was greater in the GSW cohort (odds ratio, 2.38; 95% confidence interval, 1.14-5.80), and requirements were increased for all four blood components (red blood cells, platelets, plasma, and cryoprecipitate). Patients with GSWs had approximately 14 times greater overall mortality (653 of 2672 [24.4%] vs. 352 of 20,750 [1.7%]; p < 0.0001]. Compared to non-GSW penetrating injuries (e.g., stab wounds), those with GSWs had approximately four times higher transfusion requirements (3.3 ± 13.5 vs. 0.80 ± 3.8 units/patient; p < 0.0001), and approximately eight times greater overall mortality (653 of 2672 [24.4%] vs. 28 of 956 [2.9%]; p < 0.0001). CONCLUSIONS: Compared to other traumatic injuries, GSW injuries are associated with substantially greater blood utilization and mortality. Trauma centers treating GSW injuries should have ready access to all blood components and ability to implement massive transfusions.

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Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

October 2018

Volume

58

Issue

10

Start / End Page

2326 / 2334

Location

United States

Related Subject Headings

  • Wounds, Gunshot
  • Trauma Centers
  • Retrospective Studies
  • Humans
  • Gun Violence
  • Cardiovascular System & Hematology
  • Blood Transfusion
  • 3204 Immunology
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
 

Citation

APA
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DeMario, V. M., Sikorski, R. A., Efron, D. T., Serbanescu, M. A., Buchanan, R. M., Wang, E. J., … Frank, S. M. (2018). Blood utilization and mortality in victims of gun violence. Transfusion, 58(10), 2326–2334. https://doi.org/10.1111/trf.14925
DeMario, Vincent M., Robert A. Sikorski, David T. Efron, Mara A. Serbanescu, Rica M. Buchanan, Eric J. Wang, Mereze Visagie, et al. “Blood utilization and mortality in victims of gun violence.Transfusion 58, no. 10 (October 2018): 2326–34. https://doi.org/10.1111/trf.14925.
DeMario VM, Sikorski RA, Efron DT, Serbanescu MA, Buchanan RM, Wang EJ, et al. Blood utilization and mortality in victims of gun violence. Transfusion. 2018 Oct;58(10):2326–34.
DeMario, Vincent M., et al. “Blood utilization and mortality in victims of gun violence.Transfusion, vol. 58, no. 10, Oct. 2018, pp. 2326–34. Pubmed, doi:10.1111/trf.14925.
DeMario VM, Sikorski RA, Efron DT, Serbanescu MA, Buchanan RM, Wang EJ, Visagie M, Gehrie EA, Manukyan MC, Noll K, Ken Lee KH, Ness PM, Frank SM. Blood utilization and mortality in victims of gun violence. Transfusion. 2018 Oct;58(10):2326–2334.
Journal cover image

Published In

Transfusion

DOI

EISSN

1537-2995

Publication Date

October 2018

Volume

58

Issue

10

Start / End Page

2326 / 2334

Location

United States

Related Subject Headings

  • Wounds, Gunshot
  • Trauma Centers
  • Retrospective Studies
  • Humans
  • Gun Violence
  • Cardiovascular System & Hematology
  • Blood Transfusion
  • 3204 Immunology
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology