ABO blood types and sepsis mortality

ABO Blood Group and Risk Associated With Sepsis-Associated Thrombocytopenia: A Single-Center Retrospective Study

OBJECTIVES

This study aimed to investigate the relationship between ABO blood group and sepsis-associated thrombocytopenia (SAT).

DESIGN AND SETTING

The primary outcome was SAT within the first 72 hours of ICU admission.

PATIENTS

The retrospective study included 9113 patients diagnosed with sepsis from January 2014 to December 2022. A total of 6296 patients eventually were included into the study, who were divided into four groups based on ABO blood group.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

A total of 2494 patients (39.6%) were diagnosed with SAT, and 712 (11.3%) of them experiencing severe SAT. The occurrence of SAT among the ABO blood groups was significantly lower in AB blood group compared with the other groups ( p = 0.032). Individuals in AB blood group were less likely to experience severe SAT ( p = 0.028). In multivariate analysis, B blood group (odds ratio [OR], 1.32; 95% CI, 1.05-1.67) and O (OR, 1.37; 95% CI, 1.09-1.72) were significantly associated with a higher occurrence of SAT compared with AB blood group. In multivariate analyses, A blood group (OR, 1.68; 95% CI, 1.16-2.42), B blood group (OR, 1.74; 95% CI, 1.74-2.50), and O blood group (OR, 1.72; 95% CI, 1.20-2.48) remained significantly risk factors associated with a higher occurrence of severe SAT compared with AB blood group.

CONCLUSIONS

B blood group and O were associated with an increased risk of SAT and severe SAT.

ABO Blood Type and Short-Term Mortality in Patients With Infection-Associated Disseminated Intravascular Coagulation

BACKGROUND

Disseminated intravascular coagulation (DIC) is a devastating disease of the coagulation system. We examined the association between ABO blood type and short-term mortality in patients with infection-associated DIC.

METHODS

The study cohort was drawn from the Danish Disseminated Intravascular Coagulation (DANDIC) cohort. Our subcohort was restricted to patients with infection-associated DIC. All-cause 30-day and 90-day mortality were computed by Kaplan-Meier estimates and odds ratios between ABO blood types were examined using logistic regression analysis adjusted for age, sex, comorbidity, and location of infection. Blood type O was used as a reference.

RESULTS

The DANDIC cohort included 3023 patients with DIC. Among these, 1853 (61%) had infection-associated DIC. Data on ABO blood type were unavailable in 34 patients (1.8%), who were excluded. The median age was 68 years and 58.2% were males. The 30-day mortality ranged between 38.6% and 42.5% and the 30-day mortality odds ratios were 1.15 (95% confidence interval (CI), 0.92-1.42) for blood type A; 0.84 (95% CI, 0.49-1.43) for AB; and 0.95 (95% CI, 0.67-1.33) for B compared to blood type O.

CONCLUSIONS

We found no clinically meaningful difference in short-term mortality between the various ABO blood types in patients with infection-associated DIC.

ABO and Rhesus blood groups and multiple health outcomes: an umbrella review of systematic reviews with meta-analyses of observational studies

BACKGROUND

Numerous studies have been conducted to investigate the relationship between ABO and Rhesus (Rh) blood groups and various health outcomes. However, a comprehensive evaluation of the robustness of these associations is still lacking.

METHODS

We searched PubMed, Web of Science, Embase, Scopus, Cochrane, and several regional databases from their inception until Feb 16, 2024, with the aim of identifying systematic reviews with meta-analyses of observational studies exploring associations between ABO and Rh blood groups and diverse health outcomes. For each association, we calculated the summary effect sizes, corresponding 95% confidence intervals, 95% prediction interval, heterogeneity, small-study effect, and evaluation of excess significance bias. The evidence was evaluated on a grading scale that ranged from convincing (Class I) to weak (Class IV). We assessed the certainty of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation criteria (GRADE). We also evaluated the methodological quality of included studies using the A Measurement Tool to Assess Systematic Reviews (AMSTAR). AMSTAR contains 11 items, which were scored as high (8-11), moderate (4-7), and low (0-3) quality. We have gotten the registration for protocol on the PROSPERO database (CRD42023409547).

RESULTS

The current umbrella review included 51 systematic reviews with meta-analysis articles with 270 associations. We re-calculated each association and found only one convincing evidence (Class I) for an association between blood group B and type 2 diabetes mellitus risk compared with the non-B blood group. It had a summary odds ratio of 1.28 (95% confidence interval: 1.17, 1.40), was supported by 6870 cases with small heterogeneity (I2 = 13%) and 95% prediction intervals excluding the null value, and without hints of small-study effects (P for Egger's test > 0.10, but the largest study effect was not more conservative than the summary effect size) or excess of significance (P < 0.10, but the value of observed less than expected). And the article was demonstrated with high methodological quality using AMSTAR (score = 9). According to AMSTAR, 18, 32, and 11 studies were categorized as high, moderate, and low quality, respectively. Nine statistically significant associations reached moderate quality based on GRADE.

CONCLUSIONS

Our findings suggest a potential relationship between ABO and Rh blood groups and adverse health outcomes. Particularly the association between blood group B and type 2 diabetes mellitus risk.

Type-O Blood Is Not Associated With Elevated Mortality After Trauma: A North American Cohort Study

BACKGROUND

Recent studies have presented contradictory findings on the relationship between blood type and mortality in trauma patients. Using the largest population in a study of this type to date, we hypothesized that ABO genotype and Rhesus status would influence trauma-related mortality and morbidity given the relationship between blood type and hemostasis.

METHODS

Data from all trauma patients admitted to level I and level II trauma centers in one city over a five-year period was retrospectively analyzed. Patients were stratified by ABO type. Patient demographics and outcomes were then assessed. Chi-squared and Fisher's exact tests were used to analyze categorical variables. Continuous variables were analyzed using ANOVA or Kruskal-Wallis tests as appropriate. Logistic regression was used to determine independent associations for 28-day mortality and complications.

RESULTS

Of 5249 patients, severe injury (ISS >15) was present in 1469. Approximately one-quarter of patients with severe injury received blood products within the first 24 hours. There were no significant variations in demographics or complications between patients of different blood types. Univariate and multivariable regression analysis showed no association between blood type and mortality. However, penetrating injury, lower GCS, higher ISS, blood transfusion within 24 hours, and Asian descent were associated with higher overall mortality.

CONCLUSIONS

In contrast to previous studies, we found no evidence of an association between blood type and mortality. However, our findings suggest that patients of Asian descent may be at higher risk for mortality following trauma. Further research is warranted to explore this observation.

Analysis of Clinical Characteristics and Blood Cell in Adult Patients with Brucella Bloodstream Infection of Different Blood Groups

The clinical manifestations and blood cell varied among patients with Brucella bloodstream infection. This study aimed to explore the clinical characteristics and blood cells of adult Brucella bloodstream infection patients with different ABO blood groups. This study retrospectively analyzed 77 adult Brucella bloodstream infection patients. Demographic characteristics, clinical manifestations, laboratory data, and blood cell differences of adult Brucella bloodstream infection patients were analyzed. For Brucella bloodstream infection patients, the blood group was distributed as: B > O > A > AB. The main symptoms of the patients were fever (94.81%), and 56 patients (72.70%) were complicated with liver injury. The highest proportion of liver injury was 93.33% in patients with blood group A and 52.38% in blood group O (P < 0.05). There were 19 cases (24.68%) with spondylitis, 30 cases (38.96%) with anemia, 28 (36.36%) with leukopenia, 16 (20.78%) with thrombocytopenia, without notable differences between different blood groups (P > 0.05). The proportion of lymphocytes in patients with the AB blood group was the highest (39.46 ± 11.21), and in patients with the B blood group was the lowest (28.00 ± 12.10), with significant difference between different blood groups (P < 0.05). Patients with Brucella bloodstream infection with blood group A were more prone to liver injury than those with blood group O. More attention should be paid to liver injury when receiving patients with blood group A. The proportion of lymphocytes in patients with blood group B and AB was different, suggesting that they may have different immune states.

ABO and RhD blood group are not associated with mortality and morbidity in critically ill patients; a multicentre observational study of 29 512 patients

Background

The ABO and RhD blood group represent antigens on the surface of erythrocytes. The ABO blood group antigens are also present on multiple other cells. Interestingly, previous studies have demonstrated associations between the blood group and many types of disease. The present study aimed to identifying associations between the ABO blood group, the RhD blood group, and morbidity and mortality in a mixed cohort and in six pre-defined subgroups of critically ill patients.

Methods

Adult patients admitted to any of the five intensive care units (ICUs) in the Scania Region, Sweden, between February 2007 and April 2021 were eligible for inclusion. The outcomes were mortality analysed at 28– and 90–days as well as at the end of observation and morbidity measured using days alive and free of (DAF) invasive ventilation (DAF ventilation) and DAF circulatory support, including vasopressors or inotropes (DAF circulation), maximum Sequential Organ Failure Assessment score (SOFAmax) the first 28 days after admission and length of stay. All outcomes were analysed in separate multivariable regression models adjusted for age and sex. In addition, in a sensitivity analysis, five subgroups of patients with the main diagnoses sepsis, septic shock, acute respiratory distress syndrome, cardiac arrest and trauma were analysed using the same separate multivariable regression models.

Results

In total, 29,512 unique patients were included in the analyses. There were no significant differences for any of the outcomes between non-O blood groups and blood group O, or between RhD blood groups. In the sensitivity analysis of subgroups, there were no differences in mortality between non-O blood groups and blood group O or between the RhD blood groups. AB was the most common blood group in the COVID-19 cohort.

Conclusions

The ABO and RhD blood group do not influence mortality or morbidity in a general critically ill patient population.