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Severe trauma patients with Blood group O have high Mortality

Severe trauma patients with Blood group O have high Mortality
The study was conducted by Wataru Takayama, Trauma and Acute Critical Care Medical Center, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan, and his Japanese counterparts, to examine the impact of the difference in the ABO blood type on mortality in patients with severe trauma.
Blood type is determined by proteins on the surfaces of red blood cells. The other blood group categories are A, B, and AB. Type O blood can generally be donated to anyone with no ill-effects, and hence is called a universal blood type. However, people with type O blood have lower levels of von Willebrand factor, a blood-clotting agent that may help in the prevention of life-threatening bleeding (hemorrhage).
The study involved a retrospective observational study of 901 Japanese emergency care patients. Based on which, the researchers found that blood type O was associated with high mortality of 28% as compared to a rate of 11% in patients with other blood types. Furthermore, blood type O was significantly associated with higher cause-specific mortalities.

Dr. Takayama, the corresponding author said: “Recent studies suggest that blood type O could be a potential risk factor for hemorrhage (bleeding in large quantities). Loss of blood is the leading cause of death in patients with severe trauma but studies on the association between different blood types and the risk of trauma death have been scarce. We wanted to test the hypothesis that trauma survival is affected by differences in blood types.”

The authors suggest that the possible explanation of the high death rate in trauma patients with blood type O is lower levels of von Willebrand factor. Wataru Takayama said: “Our results also raise questions about how emergency transfusion of O type red blood cells to a severe trauma patient could affect homeostasis, the process which causes bleeding to stop, and if this is different from other blood types. Further research is necessary to investigate the results of our study and develop the best treatment strategy for severe trauma patients.”

The authors caution that all the patients whose data were analyzed in this study were Japanese and therefore there is a need for further research to understand if the findings apply to other ethnic groups. Additionally, there was no evaluation of the impact of the individual blood types A, AB or B on severe trauma death rates. Instead, the authors compared type O to non-O blood type which may have diluted the effect of individual blood types on patient survival.

The authors concluded that blood type O was significantly associated with high mortality in severe trauma patients and might have a great impact on outcomes. Further studies elucidating the mechanism underlying this association are warranted to develop the appropriate intervention.

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Source: With inputs from Critical Care

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