The impact of blood type O on mortality of severe trauma patients: a retrospective observational study

Abstract

BackgroundRecent studies have implicated the differences in the ABO blood system as a potential risk for various diseases, including hemostatic disorders and hemorrhage. In this study, we evaluated the impact of the difference in the ABO blood type on mortality in patients with severe trauma.MethodsA retrospective observational study was conducted in two tertiary emergency critical care medical centers in Japan. Patients with trauma with an Injury Severity Score (ISS) > 15 were included. The association between the different blood types (type O versus other blood types) and the outcomes of all-cause mortality, cause-specific mortalities (exsanguination, traumatic brain injury, and others), ventilator-free days (VFD), and total transfusion volume were evaluated using univariate and multivariate competing-risk regression models. Moreover, the impact of blood type O on the outcomes was assessed using regression coefficients in the multivariate analysis adjusted for age, ISS, and the Revised Trauma Score (RTS).ResultsA total of 901 patients were included in this study. The study population was divided based on the ABO blood type: type O, 284 (32%); type A, 285 (32%); type B, 209 (23%); and type AB, 123 (13%). Blood type O was associated with high mortality (28% in patients with blood type O versus 11% in patients with other blood types; p < 0.001). Moreover, this association was observed in a multivariate model (adjusted odds ratio = 2.86, 95% confidence interval 1.84–4.46; p < 0.001). The impact of blood type O on all-cause in-hospital mortality was comparable to 12 increases in the ISS, 1.5 decreases in the RTS, and 26 increases in age. Furthermore, blood type O was significantly associated with higher cause-specific mortalities and shorter VFD compared with the other blood types; however, a significant difference was not observed in the transfusion volume between the two groups.ConclusionsBlood type O was significantly associated with high mortality in severe trauma patients and might have a great impact on outcomes. Further studies elucidating the mechanism underlying this association are warranted to develop the appropriate intervention.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2022-0) contains supplementary material, which is available to authorized users.

The impact of blood type on transfusion after major emergency abdominal surgery

“…However, a very recent study reported an increased all‐cause mortality (adjusted OR 2.86) in 901 severely injured trauma patients with type O vs type non‐O. Though the difference in transfusion volume did not reach statistical significance, there was a tendency toward increased hemorrhage in type O patients.…”

“…A meta‐analysis of surgical and non‐surgical patients showed a significant increase in hemorrhage in patients with type O compared with non‐O, whereas there is contradictory results both for and against an increased need for transfusion in relation to surgery in patients with type O. Recently, an increased mortality due to trauma induced hemorrhage was reported in patients with type O . The impact of ABO blood type on perioperative transfusion has however, not previously been investigated in major emergency abdominal surgery.…”

ABO blood type compatibility is not a risk factor for gestational trophoblastic neoplasia development from androgenetic complete hydatidiform moles

“…Besides the immunological hypothesis, another possible explanation for the relationship between ABO blood type and GTN occurrence is that coagulation activity or cell adhesion molecules may be related to ABO blood type. Recently, the relationship between ABO blood type and disease or the various pathological conditions, such as thrombotic vascular diseases, 9 coronary artery disease, 7 cancer development, 6 and mortality of severe trauma, 10 has been reported. AB blood type could be related to coagulation tendency as thrombotic features 9 .…”

“…In addition to their expression on red blood cells, ABO antigens are expressed in other human cells and tissues 5 . Recently, numerous studies about the relationship between ABO blood types and various diseases have been reported 6‐10 . A few studies indicated the effect of ABO blood types on the outcomes of pregnancy, such as preeclampsia, 11 but the effects were discordant among the studies.…”

Feasibility of a Modified SCC Method With and Without Combining the Use of PGA Sheets and Fibrin Glue for Preventing Delayed Bleeding After Gastric ESD

“…Continuation or cessation of antithrombotic agents was determined according to the Guidelines for Gastroenterological Endoscopy in Patients Undergoing Antithrombotic Treatment [12][13]. We examined ABO blood type because it has been reported that blood type O may be less likely to clot than other types [14].…”