TY  - JOUR
PY  - 2021//
TI  - Blood transfusions in gunshot-wound-related emergency department visits and hospitalizations in the United States
JO  - Transfusion
A1  - Goel, Ruchika
A1  - Zhu, Xianming
A1  - Makhani, Sarah
A1  - Petersen, Molly R.
A1  - Josephson, Cassandra D.
A1  - Katz, Louis M.
A1  - Shaz, Beth H.
A1  - Austin, Richard
A1  - Crowe, Elizabeth P.
A1  - Ness, Paul M.
A1  - Gehrie, Eric A.
A1  - Frank, Steven M.
A1  - Bloch, Evan M.
A1  - Tobian, Aaron A. R.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: The United States (US) leads all high-income countries in gunshot wound (GSW) deaths. However, previous US studies have not evaluated the national blood transfusion utilization patterns in hospitalized GSW patients. <br><br>METHODS: Data from 2016 to 2017 were analyzed from the Nationwide Emergency Department Sample (NEDS) and Nationwide Inpatient Sample (NIS), the largest all-payer emergency department (ED) and inpatient databases, respectively. Using stratified probability sampling, weights were applied to generate nationally representative estimates. Multivariable Poisson-regression models were used to estimate prevalence ratios (PR) of blood transfusion. <br><br>RESULTS: There were 168,315 ED visits and 58,815 hospitalizations (age = 18-90 years) following a GSW. The majority of hospitalizations were men (88.5%), age 18-24 years (31.8%), and assault-related GSW (51.3%). Blacks had the largest proportion (48.7%) overall of all GSW hospitalizations; Whites accounted for the highest proportion of intentional self-harm injuries (72.4%). Blood transfusions occurred in 12.7% of hospitalizations (12.0% red blood cell [RBC], 4.9% plasma, and 2.5% platelet transfusions). Only 1.9% of cases were associated with transfusion of all three blood components. Hospitalizations with major/extreme severity of illness had significantly higher prevalence of transfusion versus those with mild/moderate severity [crude PR = 4.79 (95%CI:4.15-5.33, p < .001)]. Overall, 8.2% of hospitalizations with GSW died, of whom 26.8% required blood transfusions, which was significantly higher than survivors [crude PR = 2.34 (95%CI:2.10-2.61, p < .001)]. The vast majority (95%) of the transfusions among those who died were within 48 h since admission. <br><br>CONCLUSIONS: Gun-related violence is a public health emergency in the US, and GSWs are a source of significant mortality, blood utilization, and health care costs.<p />  <p>Language: en</p>
LA  - en
SN  - 0041-1132
UR  - http://dx.doi.org/10.1111/trf.16552
ID  - ref1
ER  -