Introduction: Transfusion of packed red blood cells (PRBC) or low-titer group O whole blood (LTOWB) has become standard practice in trauma patients with significant blood loss. As blood ages, it undergoes metabolic and structural changes. This study aimed to test the association between the age of PRBC/LTOWB and mortality among adult trauma patients. Methods: This is a retrospective cohort study at an academic level one trauma center. Adult trauma patients who received at least one unit of PRBC or LTOWB within the first hour of arrival to the emergency department (ED) between January 2016 and December 2019 were included. The primary outcome was in-hospital mortality. Multivariable logistic regression models were used to test the associations between the mean age of PRBC and LTOWB units transfused during the initial 24 hours and in-hospital mortality. Results: Of 388 patients included, 362 received PRBC and 121 received LTOWB. In-hospital mortality occurred in 31% of patients. The median (interquartile range) mean age of transfused PRBC units was 21 (16-26) days, and LTOWB units was 11 (9-12) days. Neither age of PRBC nor LTOWB was found to be associated with in-hospital mortality: PRBC adjusted odds ratio (aOR) = 0.99 (95% CI 0.95 to 1.03) and LTOWB aOR = 1.12 (95% CI 0.88 to 1.41). Conclusion: The mean age of LTOWB or PRBC units transfused during the first 24 hours after presenting to the ED for a traumatic injury was not found to be associated with in-hospital mortality.
Sarkisian et al. (Sun,) studied this question.