BLOOD TYPE O IS A RISK FACTOR FOR HYPERFIBRINOLYSIS AND MASSIVE TRANSFUSION AFTER SEVERE INJURY.
BLOOD TYPE O IS A RISK FACTOR FOR HYPERFIBRINOLYSIS AND MASSIVE TRANSFUSION AFTER SEVERE INJURY.
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血型O是严重损伤后高纤维蛋白溶解和大量输血的危险因素。
DOI：
10.1097/shk.0000000000002013
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发表时间：
2022-12-01
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Blood type O is the most common blood type and has lower von Willebrand factor (vWF) levels (25–35% lower than non-O blood types). vWF is important for initiating platelet attachment and binding Factor VIII. We hypothesized that patients with type O blood are at increased risk of trauma-induced coagulopathy (TIC) and bleeding post-injury. Adult trauma activations with known blood type at a Level I Trauma Center with field systolic blood pressure (SBP)<90mmHg were studied retrospectively. The relationships of blood group-O vs. non-O to coagulation assays, massive transfusion (MT), ventilator-free days, and mortality were adjusted for confounders. Hyperfibrinolysis (HF) was defined as thrombelastogram (TEG) LY30>3% and fibrinolysis shutdown as LY30<0.9%. VWF activity was quantified on 212 injured patients using a STAGO apparatus. Overall, 268 patients met criteria. Type O patients were more likely to develop HF than non-O blood patients (43% vs. 29%, p=0.06) and had significantly lower vWF activity (222% vs. 249%, p=0.01). After adjustment for new injury severity score (NISS) and blunt mechanism, type O had higher odds of HF (OR: 1.94, 95% CI:1.09–3.47) and increased odds of MT (OR: 3.02, 95% CI:1.22–7.49). Other outcomes were not significantly affected. Type O patients with hypotension had increased HF and MT post-injury and these were associated with lower vWF activity. These findings have implications for the monitoring of hyperfibrinolysis in patients receiving type O whole blood transfusions post-injury.
