The impact of blood type on the mortality of patients with severe abdominal trauma: a multicenter observational study
Wataru Takayama, Akira Endo, Kiyoshi Murata, Kota Hoshino, Shiei Kim, Hiroharu Shinozaki, Keisuke Harada, Hiroaki Nagano, Masahiro Hagiwara, Atsuhito Tsuchihashi, Nagato Shimada, Naomi Kitamura, Shunsuke Kuramoto, Yasuhiro Otomo
Abstract
Few studies have investigated the relationship between blood type and trauma outcomes according to the type of injury. We conducted a retrospective multicenter observational study in twelve emergency hospitals in Japan. Patients with isolated severe abdominal injury (abbreviated injury scale for the abdomen ≥ 3 and that for other organs < 3) that occurred between 2008 and 2018 were divided into four groups according to blood type. The association between blood type and mortality, ventilator-free days (VFD), and total transfusion volume were evaluated using univariate and multivariate regression models. A total of 920 patients were included, and were divided based on their blood type: O, 288 (31%); A, 345 (38%); B, 186 (20%); and AB, 101 (11%). Patients with type O had a higher in-hospital mortality rate than those of other blood types (22% vs. 13%, p < 0.001). This association was observed in multivariate analysis (adjusted odds ratio [95% confidence interval] = 1.48 [1.25-2.26], p = 0.012). Furthermore, type O was associated with significantly higher cause-specific mortalities, fewer VFD, and larger transfusion volumes. Blood type O was associated with significantly higher mortality and larger transfusion volumes in patients with isolated severe abdominal trauma.