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Sun GH, Ortoleva JP, Lu SY, Vanneman MW, Tanaka K, Mazzeffi M, Dalia AA. ABO Blood Group and Bleeding and Survival in VA-ECMO Patients. J Intensive Care Med 2023; 38:1015-1022. [PMID: 37291851 DOI: 10.1177/08850666231178759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
ABO blood group has been shown to be a major determinant of plasma von Willebrand factor (vWF) levels. O blood group is associated with the lowest vWF levels and confers an increased risk of hemorrhagic events, while AB blood group has the highest levels and is associated with thromboembolic events. We hypothesized in extracorporeal membrane oxygenation (ECMO) patients that O blood type would have the highest and AB blood type would have the lowest transfusions, with an inverse relationship to survival. A retrospective analysis of 307 VA-ECMO patients at a major quaternary referral hospital was performed. The distribution of blood groups included 124 group O (40%), 122 group A (40%), 44 group B (14%), and 17 group AB (6%) patients. Regarding usage of packed red blood cells, fresh frozen plasma, and platelets, there was a non-statistically significant difference in transfusions, with group O having the least and group AB having the most requirements. However, there was a statistically significant difference in cryoprecipitate usage when comparing to group O: group A (1.77, 95% CI: 1.05-2.97, P < .05), group B (2.05, 95% CI: 1.16-3.63, P < .05), and group AB (3.43, 95% CI: 1.71-6.90, P < .001). Furthermore, a 20% increase in length of days on ECMO was associated with a 2-12% increase in blood product usage. The cumulative 30-day mortality rate for groups O and A was 60%, group B was 50%, and group AB was 40%; the 1-year mortality rate for groups O and A was 65%, group B was 57%, and group AB was 41%; however, the mortality differences were not statistically significant.
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Affiliation(s)
- Gina H Sun
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jamel P Ortoleva
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA, USA
| | - Shu Y Lu
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Matthew W Vanneman
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford Hospital, Palo Alto, CA, USA
| | - Kenichi Tanaka
- Department of Anesthesiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Michael Mazzeffi
- Department of Anesthesiology, University of Virginia Health University Hospital, Charlottesville, VA, USA
| | - Adam A Dalia
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
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Tutunjian AM, Arabian SS, Paolino J, Wolfe ES, Mahoney EJ, Hojman HM, Johnson BP, Bugaev N. ABO blood groups do not predict progression of traumatic intracranial hemorrhage. J Clin Neurosci 2021; 90:345-350. [PMID: 34275573 PMCID: PMC8290093 DOI: 10.1016/j.jocn.2021.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 12/25/2020] [Accepted: 06/14/2021] [Indexed: 11/21/2022]
Abstract
ABO blood groups are associated with genetically predisposed variations in von Willebrand factor (VWF) resulting in higher risks of thrombotic events in non-O blood types and bleeding complications in blood type O. The role of ABO blood groups in progression of traumatic intracranial hemorrhage (TICH) is unknown. Given statistically lower VWF levels in blood type O in the general population, we hypothesized that blood type O patients have a higher risk of such progression. A retrospective review of adult trauma patients with isolated TICH admitted to a Level 1 trauma center over eight years was conducted. Patients were categorized with blood type O and non-O (types A, B, AB) delineation. The primary outcome was radiological progression of TICH during the first 24 h. Secondary outcomes included surgical intervention after follow-up computed tomography (CT), complications, days on mechanical ventilation (DMV), intensive care unit (ICU) length of stay (LOS), hospital LOS, and mortality. Of 949 patients, 432 (45.5%) had blood type O. When comparing O and non-O groups, no significant differences were found in gender, age, race, admission vital signs, Glasgow Coma Scale, coagulation profile, TICH type, or Injury Severity Score. No difference in TICH progression was found between O and non-O groups: 73 (17%) vs 80 (15%), respectively, p = 0.55. Blood type O mortality was 12 (3% vs. 23 (4%), p = 0.174). Rate of TICH surgical intervention after follow-up CT, DMV, complications, and ICU and hospital LOS did not differ. No association between ABO blood types and radiological progression of TICH was identified.
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Affiliation(s)
- Alyssa M Tutunjian
- Tufts University School of Medicine, 145 Harrison Ave, Boston, MA 02111, United States.
| | - Sandra S Arabian
- Division of Trauma & Acute Care Surgery, Department of Surgery, Tufts Medical Center, 800 Washington St, #4488, Boston, MA 02111, United States.
| | - Jacqueline Paolino
- Department of Surgery, Tufts Medical Center, 800 Washington St, Boston, MA 02111, United States
| | - Elizabeth S Wolfe
- Division of Trauma & Acute Care Surgery, Department of Surgery, Tufts Medical Center, 800 Washington St, #4488, Boston, MA 02111, United States
| | - Eric J Mahoney
- Division of Trauma & Acute Care Surgery, Department of Surgery, Tufts Medical Center, 800 Washington St, #4488, Boston, MA 02111, United States.
| | - Horacio M Hojman
- Division of Trauma & Acute Care Surgery, Department of Surgery, Tufts Medical Center, 800 Washington St, #4488, Boston, MA 02111, United States.
| | - Benjamin P Johnson
- Division of Trauma & Acute Care Surgery, Department of Surgery, Tufts Medical Center, 800 Washington St, #4488, Boston, MA 02111, United States.
| | - Nikolay Bugaev
- Division of Trauma & Acute Care Surgery, Department of Surgery, Tufts Medical Center, 800 Washington St, #4488, Boston, MA 02111, United States.
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Goodman M, Li J, Flanders WD, Mahood D, Anthony LG, Zhang Q, LaKind JS. Epidemiology of PCBs and neurodevelopment: Systematic assessment of multiplicity and completeness of reporting. GLOBAL EPIDEMIOLOGY 2020. [DOI: 10.1016/j.gloepi.2020.100040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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