Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain Injury
Table 1
Characteristics of patients according to the occurrence of anemia (nadir hemoglobin less than 10 g/dL) during stay in the intensive care unit and packed red blood cell transfusion status.
All patients = 101
Anemia during stay = 48
No anemia during stay = 53
value
PRBC transfusion = 21
No PRBC transfusion = 80
value
Age (years), mean ± SD
29.0 ± 14.4
32.1 ± 16.3
26.3 ± 11.9
0.04
30.8 ± 14.8
28.6 ± 14.3
0.54
Male gender, (%)
96 (95)
44 (91.7)
52 (98.1)
0.19
21 (100)
75 (93.8)
0.58
Body mass index (Kg/m2), mean ± SD
24.1 ± 4.9
23.4 ± 3.8
24.6 ± 5.6
0.25
23.3 ± 3.5
24.3 ± 5.2
0.42
Preexisting diabetes, (%)
4 (4)
1 (2.1)
3 (5.7)
0.42
0 (0)
4 (5.0)
0.58
Preexisting hypertension, (%)
6 (5.9)
4 (8.3)
2 (3.8)
1.000
1 (4.8)
5 (6.3)
1.0
GCS score on admission, mean ± SD
6.8 ± 3.5
6.3 ± 3.1
7.3 ± 3.7
0.15
6.0 ± 3.2
7.0 ± 3.5
0.25
Patients with GCS score ≤ 8, (%)
81 (80.2)
41 (85.4)
40 (75.5)
0.21
17 (81.0)
64 (80.0)
1.0
APACHE II, mean ± SD
17.9 ± 6.4
18.2 ± 5.0
17.6 ± 7.4
0.70
18.6 ± 5.0
17.7 ± 6.7
0.60
Injury Severity Score, mean ± SD
20.3 ± 7.2
22.3 ± 6.5
18.5 ± 7.4
0.01
22.0 ± 6.8
19.9 ± 7.3
0.25
Type of brain injury, (%)
Subdural hematoma
25 (24.8)
19 (39.6)
6 (11.3)
0.001
11 (52.4)
14 (17.5)
0.001
Epidural hematoma
21 (20.8)
11 (22.9)
10 (18.9)
0.62
4 (19.0)
17 (21.3)
1.0
Subarachnoid haemorrhage
28 (27.7)
12 (25.0)
16 (30.2)
0.56
2 (9.5)
26 (32.5)
0.04
Intracerebral haemorrhage
18 (17.8)
9 (18.8)
9 (17.0)
0.82
6 (28.6)
12 (15.0)
0.20
Intraventricular haemorrhage
13 (12.9)
4 (8.3)
9 (17.0)
0.20
1 (4.8)
12 (15.0)
0.29
Brain contusion
19 (18.8)
5 (10.4)
14 (26.4)
0.04
2 (9.5)
17 (21.3)
0.35
Diffuse axonal injury
9 (8.9)
2 (4.2)
7 (13.2)
0.16
2 (9.5)
7 (8.8)
1.0
Hemoglobin on admission (g/dL), mean ± SD
14.1 ± 2.1
13.4 ± 1.9
14.7 ± 1.9
0.002
13.0 ± 2.1
14.4 ± 1.9
0.004
PaO2 : , mean ± SD
316 ± 107
336 ± 107
297 ± 104
0.13
364 ± 117
306 ± 103
0.08
MAP on day 1 (mmHg), mean ± SD
91 ± 8
91 ± 8
89 ± 8
0.58
95 ± 5
88 ± 8
0.04
ICP on day 1 (mmHg), mean ± SD
17 ± 11
19 ± 12
14 ± 8
0.41
23 ± 14
14 ± 7
0.09
CPP on day 1 (mmHg), mean ± SD
73 ± 10
73 ± 11
75 ± 7
0.63
71 ± 13
74 ± 8
0.47
Management in the intensive care unit, (%)
Mechanical ventilation
98 (97.0)
48 (100.0)
50 (94.3)
0.24
21 (100)
77 (96.3)
1.0
Head injury protocol
76 (75.2)
42 (87.5)
34 (64.2)
0.01
19 (90.5)
57 (71.3)
0.07
Craniotomy
31 (30.7)
24 (50.0)
7 (13.2)
<0.001
9 (42.9)
22 (27.5)
0.17
ICP management
32 (31.7)
21 (43.8)
11 (20.8)
0.01
11 (52.4)
21 (26.3)
0.02
PRBC transfusion
21 (20.8)
19 (39.6)
2 (3.8)
<0.001
21 (100)
0 (0)
0.0001
Other transfusions
15 (14.9)
14 (29.2)
1 (1.9)
0.0001
8 (38.1)
7 (8.8)
0.002
APACHE: Acute Physiology and Chronic Health Evaluation; CPP: cerebral perfusion pressure; GCS: Glasgow Coma Scale; ICP: intracranial pressure; MAP: mean arterial pressure; PaO2/FiO2: the ratio of partial pressure of oxygen to the fraction of inspired oxygen; PRBC: packed red blood cell; SD: standard deviation. One patient may have more than one type of brain injury. For example, 9 patients with subdural hematoma had other injuries. Missing data for 31 patients. Applies to patients who had intracranial pressure monitoring; only one patient who did not develop anemia during stay had intracranial pressure monitoring. Platelets and/or fresh frozen plasma.
