Type-O Blood Is Not Associated With Elevated Mortality After Trauma: A North American Cohort Study.

BACKGROUND: Recent studies have presented contradictory findings on the relationship between blood type and mortality in trauma patients. Using the largest population in a study of this type to date, we hypothesized that ABO genotype and Rhesus status would influence trauma-related mortality and morbidity given the relationship between blood type and hemostasis. METHODS: Data from all trauma patients admitted to level I and level II trauma centers in one city over a five-year period was retrospectively analyzed. Patients were stratified by ABO type. Patient demographics and outcomes were then assessed. Chi-squared and Fisher's exact tests were used to analyze categorical variables. Continuous variables were analyzed using ANOVA or Kruskal-Wallis tests as appropriate. Logistic regression was used to determine independent associations for 28-day mortality and complications. RESULTS: Of 5249 patients, severe injury (ISS >15) was present in 1469. Approximately one-quarter of patients with severe injury received blood products within the first 24 hours. There were no significant variations in demographics or complications between patients of different blood types. Univariate and multivariable regression analysis showed no association between blood type and mortality. However, penetrating injury, lower GCS, higher ISS, blood transfusion within 24 hours, and Asian descent were associated with higher overall mortality. CONCLUSIONS: In contrast to previous studies, we found no evidence of an association between blood type and mortality. However, our findings suggest that patients of Asian descent may be at higher risk for mortality following trauma. Further research is warranted to explore this observation.

Is there a gender bias in milestones evaluations in general surgery residency training?

BACKGROUND: Studies of gender disparity in surgical training have yielded conflicting results. We hypothesize that there is no influence of gender on resident self-evaluation Milestone (SEM) scores and those assigned by the Clinical Competency Committee (CCC). METHODS: 42 residents (25 male & 17 female) and faculty completed 300 Accreditation Council for Graduate Medical Education (ACGME) Milestone evaluations over a 4-year period. Two-way ANOVA, intraclass correlations coefficients, and general linear mixed models were used for analysis. RESULTS: CCC Milestone scores from 150 evaluations, 51 (34%) for female residents and 99 (66%) for male residents, were compared to corresponding SEM scores. There is a high interrater reliability (self vs. CCC). There was a significant increase in scores with advancing PGY levels (p < 0.001). No effect of gender on Milestones scores (p > 0.05) was noted. CONCLUSIONS: We found no significant differences in Milestones scores between male and female residents as determined by the CCC. Both scores improved significantly as residents progressed in training.