| dc.description.abstract | BACKGROUND: ABO group alters coagulation profiles in the general population and may influence outcomes after trauma. The relationship between trauma-induced coagulopathy, severe injury with haemorrhagic shock, and survival with respect to ABO group is unknown. OBJECTIVES: In severe haemorrhagic trauma we aimed to characterize the association of ABO group with admission coagulation profiles, mortality, and immune-mediated complications. PATIENTS AND METHODS: Clinical and laboratory variables were examined from severely injured adult patients enrolled into a perpetual observational cohort study at a UK Major Trauma Centre. Univariate and multivariate analyses were performed to determine differences in clinical outcomes (mortality, organ dysfunction, critical care support). In a shock subgroup, we performed an exploratory analysis of ROTEM parameters and coagulation biomarkers. RESULTS: In 1,119 trauma patients we found no difference in mortality between ABO groups. In patients with shock, 24-hr mortality was significantly lower in group B vs non-B groups (7% vs 16%, aOR 0.19, p = 0.030) but there were increased rates of invasive ventilation (aOR 3.34, p = 0.033), Renal Replacement Therapy (aOR 2.55, p = 0.037), and a trend for infection (aOR 1.85, p = 0.067). Comparing patients with shock, group B vs non-B patients had 40% higher fibrinogen, 65% higher Factor VIII, 36% higher Factor IX, 20% higher Factor XIII, and 19% higher vWF. CONCLUSIONS: In this observational study limited by single time-point sampling and subgroup analysis of trauma haemorrhage with shock, group B patients have enhanced haemostatic capability associated with early survival but with increased risk of immune-mediated complications. | en_US |
