Blood transfusion is an independent predictor of mortality after blunt trauma.

Allogeneic blood transfusion is associated with increased morbidity and mortality. The authors evaluated the affect of blood transfusion, independent of injury severity on mortality. The authors conducted a retrospective review of all patients, age > or =18 years with blunt injury admitted to their Level 2 trauma center from 1994 to 2004 by query of the NTRACS trauma registry. Initial systolic blood pressure and heart rate determined the shock index. Logistic regression was used to model the affect of blood transfusion on mortality. Transfusion requirements were categorized as follows: A, 0 U; B, 1 to 2 U; C, 3 to 5 U; D, > or =6 U blood. In this sample of 8215 blunt trauma patients, 324 patients received blood transfusion. Mortality rates between the transfused and nontransfused groups were 15.12 per cent and 1.84 per cent (P < 0.000) respectively. In the logistic regression model, transfusion category B did not have a significant affect on the odds of death (P = 0.176); the affect of transfusing 3 to 5 U and > or =6 U had a mortality odds ratio of 3.22 (P = 0.002). and 4.87 (P = 0.000) respectively. Transfusing > or =2U blood was strongly associated with mortality in this blunt trauma population. There must be a continuous attempt to limit blood transfusion when feasible and physiologically appropriate.

Through the looking glass: 21st century trauma registry innovations.

Trauma registries can be invaluable tools for improving quality of care and monitoring patient outcomes, but many function below their full potential. Reliance on low-tech, manual data management methods, such as the retyping of demographic information, can lead to inefficiency, increased personnel costs, and potential error. One low-cost solution is a digital interface between the medical records coding database and the trauma registry, allowing the registrar to pull demographic information and ICD-9 diagnostic and procedure codes directly from a reliable source without re-keying them. We created a batch interface for that purpose, reducing the burden of manual data entry and decreasing the time needed to complete patient records in the registry. The interface has eliminated our backlog and allowed the trauma registrar to focus on creating timely reports to track quality indicators.