Determinants for the need for blood transfusion in trauma patients admitted to the emergency ward: a case-control study

Introduction: Trauma is a major cause of death in hospitals around the world according to the World Health Organization (WHO). Massive transfusion (MT) has specific indications in many trauma centers in the United States, but the need for definite criteria and indications for MT remains. In this study, we try to define exact indications of whether and/ when a trauma patient needs PRBCs transfusion, or even how much transfusion may be needed. Methods: This study was a retrospective analysis of the prospectively collected data of the trauma patients that have been registered in the National Trauma Registry of Iran (NTRI) from July 2016 to October 2021. Age, sex, body mass index (BMI), preexisting cardiovascular problems, endocrine issues, kidney dysfunction. Gastrointestinal diseases, whether or not the patient had multiple trauma, obesity, systolic blood pressure, pulse rate, temperature, Oxygen saturation, Glasgow coma scale (GCS), and injury severity score (ISS) were the principal variables of this study. Results: Hypotension, temperature > 37º, hyperpnea, and O2 saturation < 90% were significantly more prevalent among PRBCs receivers. Hypertension, tachycardia, and bradycardia were more prevalent as well, but the difference was not statistically significant. In terms of trauma scores, Glasgow Coma Scale (GCS) ≤ 8, and both ISS 9–14 and ≥ 15 had more chance of needing PRBCs transfusion which was meaningful, but GCS 14 − 9 didn’t prove significant chances. Conclusion: Based on these criteria, we can estimate if a patient will need a blood transfusion and make a PRBC reservation in the blood bank.