• Amélie Boutin, Lynne Moore, Robert S Green, Ryan Zarychanski, Mete Erdogan, François Lauzier, Shane English, Dean A Fergusson, Michael Butler, Lauralyn McIntyre, Michaël Chassé, Lessard Bonaventure Paule P CHU de Québec - Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical , Caroline Léger, Philippe Desjardins, Donald Griesdale, Jacques Lacroix, and Alexis F Turgeon.
• CHU de Québec - Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), Université Laval, Z-207, 1401, 18e rue, Québec, QC G1J 1Z4, Canada; Department of Social and Preventive Medicine, Université Laval, 1050, avenue de la Médecine, Québec, QC G1V 0A6, Canada. Electronic address: amelie.boutin.2@ulaval.ca.
• J Crit Care. 2018 Jun 1; 45: 133-139.

PurposeWe aimed to evaluate the association between transfusion practices and clinical outcomes in patients with traumatic brain injury.Material And MethodsWe conducted a retrospective cohort study of adult patients with moderate or severe traumatic brain injury admitted to the intensive care unit (ICU) of a level I trauma center between 2009 and 2013. The associations between hemoglobin (Hb) level, red blood cell (RBC) transfusion and clinical outcomes were estimated using robust Poisson models and proportional hazard models with time-dependent variables, adjusted for confounders.ResultsWe included 215 patients. Sixty-six patients (30.7%) were transfused during ICU stay. The median pre-transfusion Hb among transfused patients was 81g/L (IQR 67-100), while median nadir Hb among non-transfused patients was 110g/L (IQR 93-123). Poor outcomes were significantly more frequent in patients who were transfused (mortality risk ratio [RR]: 2.15 [95% CI 1.37-3.38] and hazard ratio: 3.06 [95% CI 1.57-5.97]; neurological complications RR: 3.40 [95% CI 1.35-8.56]; trauma complications RR: 1.65 [95% CI 1.31-2.08]; ICU length of stay geometric mean ratio: 1.42 [95% CI 1.06-1.92]).ConclusionsDuring ICU stay, transfused patients tended to have lower Hb levels and worse outcomes than patients who did not receive RBCs, after adjustment for confounders.Copyright © 2017 Elsevier Inc. All rights reserved.

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