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Critical Care Research and Practice
Volume 2015, Article ID 672639, 7 pages
http://dx.doi.org/10.1155/2015/672639
Research Article

Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain Injury

1Intensive Care Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia
2College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
3Epidemiology and Biostatistics, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
4Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
5Neurosurgery/Surgery Department, King Abdulaziz Medical City, Riyadh 11426, Saudi Arabia

Received 9 July 2015; Revised 2 October 2015; Accepted 11 October 2015

Academic Editor: Samuel A. Tisherman

Copyright © 2015 Hasan M. Al-Dorzi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rationale. By reducing cerebral oxygen delivery, anemia may aggravate traumatic brain injury (TBI) secondary insult. This study evaluated the impact of anemia and blood transfusion on TBI outcomes. Methods. This was a retrospective cohort study of adult patients with isolated TBI at a tertiary-care intensive care unit from 1/1/2000 to 31/12/2011. Daily hemoglobin level and packed red blood cell (PRBC) transfusion were recorded. Patients with hemoglobin < 10 g/dL during ICU stay (anemic group) were compared with other patients. Results. Anemia was present on admission in two (2%) patients and developed in 48% during the first week with hemoglobin < 7 g/dL occurring in 3.0%. Anemic patients had higher admission Injury Severity Score and underwent more craniotomy (50% versus 13%, ). Forty percent of them received PRBC transfusion (2.8 ± 1.5 units per patient, median pretransfusion hemoglobin = 8.8 g/dL). Higher hospital mortality was associated with anemia (25% versus 6% for nonanemic patients, ) and PRBC transfusion (38% versus 9% for nontransfused patients, ). On multivariate analysis, only PRBC transfusion independently predicted hospital mortality (odds ratio: 6.8; 95% confidence interval: 1.1–42.3). Conclusions. Anemia occurred frequently after isolated TBI, but only PRBC transfusion independently predicted mortality.