Does the availability of non-cross matched blood in the trauma bay effect the outcome of trauma patients? A retrospective study from a level-II trauma center.

BACKGROUND

Timely administration of blood products is critical in trauma resuscitation. Many trauma centers worldwide do not store blood products within the emergency room (ER), potentially delaying transfusion. This study evaluated the impact of immediate availability of uncrossmatched O-type packed red blood cells (UORBC) in the trauma bay on patient management and outcomes.

METHODS

We conducted a retrospective cohort study at a single level-II trauma center, comparing all trauma patients triaged to the trauma bay in the year before (April 2020-March 2021) and after (April 2021-March 2022) UORBC was stored in a dedicated trauma bay refrigerator. Demographics, injury characteristics, blood product use, surgical interventions, intensive care unit (ICU) admission, length of stay (LOS), and mortality were analyzed.

RESULTS

Of 216 patients, 74 presented pre-implementation (Yr1) and 142 post-implementation (Yr2). Baseline demographics and injury patterns were similar between groups. ER administration of packed red blood cells was significantly higher in Yr2 (5 % vs. 15 %, p = 0.04). Fewer emergent surgeries were observed post-implementation without statistical significance (38 % vs. 27 %, p = 0.09). No significant differences were found in overall hospitalization blood product use (p = 0.55), hospital LOS (7.0 vs. 5.8 days, p = 0.24), ICU LOS, mortality (2.7 % vs. 4.9 %, p = 0.72), or discharge disposition.

CONCLUSIONS

Immediate trauma bay access to UORBC increased early ER transfusion rates and showed a lower percent of patients having emergent surgeries, but did not significantly affect LOS or mortality. Larger multicenter studies are warranted to clarify clinical impact and optimize trauma system logistics.