Red blood cell transfusion and hemoglobin level on neurological outcome in the first 24 hours of traumatic brain injury

Abstract

Objectives: Target hemoglobin (Hb) level is not clearly determined in patients followed up in the intensive care unit (ICU) for traumatic brain injury (TBI). This study aims to investigate the impact of red blood cell (RBC) transfusion and Hb level on the neurological outcome in the first 24 h in patients with TBI.

Methods: In this retrospective study, we reviewed the 2-year organizational database. We evaluated data from patients who underwent RBC transfusion and whose Hb values were 7-9 g/dL and >9 g/dL in the first 24 h. We considered that a Glasgow Outcome Score (GOS) of 1-3 at the time of discharge from the ICU was a poor neurological outcome (PO) and that a GOS > 3 was a good neurological outcome (GO).

Results: A total of 147 patients were included in the study 28.6% of whom were discharged from the intensive care unit with PO. The Hb (g/dL) values of PO patients in the first 24 h were lower compared to those of GO patients (median [interquartile range]; 9.2 [2.5] vs 11 [3.4], p < 0.01). RBC transfusion of PO patients in the first 24 h was also less compared to that of GO patients (median [interquartile range]; 15 [35.7] vs. 19 [18.1], p = 0.038). In logistic regression analyses, neither RBC transfusion (OR [95%CI]; 0.786 (0.108-5.740), p = 0.81) nor Hb level (OR [95% CI]; 0.50 (0.057-4.362), p = 0.53) was an independent risk factor for PO.

Conclusion: In patients followed up in the ICU due to TBI, RBC transfusion and Hb values in the first 24 h are not associated with PO at the time of discharge from the ICU.

Keywords: Anemia; Hemoglobin; Red blood cell transfusion; Traumatic brain injury.