O blood type is not associated with worse coagulopathy or outcome in exsanguinating trauma

J Cole Gwin; Niyati Rangnekar; Glenn P Murray; Saskya Byerly; Andrew M Fleming; Thomas S Easterday; Andrew J Kerwin; Isaac W Howley

doi:10.1016/j.amjsurg.2024.03.021

O blood type is not associated with worse coagulopathy or outcome in exsanguinating trauma

Am J Surg. 2024 Mar 26:S0002-9610(24)00183-1. doi: 10.1016/j.amjsurg.2024.03.021. Online ahead of print.

Authors

J Cole Gwin¹, Niyati Rangnekar², Glenn P Murray³, Saskya Byerly⁴, Andrew M Fleming⁴, Thomas S Easterday⁴, Andrew J Kerwin⁴, Isaac W Howley⁴

Affiliations

¹ College of Medicine, University of Tennessee Health Science Center, Memphis, USA. Electronic address: jgwin2@uthsc.edu.
² Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University, Philadelphia, PA, USA.
³ College of Medicine, University of Tennessee Health Science Center, Memphis, USA.
⁴ Department of Surgery, University of Tennessee Health Science Center, Memphis, USA.

PMID: 38553336
DOI: 10.1016/j.amjsurg.2024.03.021

Abstract

Background: Despite improving understanding of trauma-induced coagulopathy (TIC), mortality and morbidity due to exsanguinating trauma remain high. Increased complications due to hemorrhage have been reported in blood group O, possibly due to reduced levels of von Willebrand factor (vWF).

Methods: An urban level 1 adult trauma center registry was retrospectively queried. Patients receiving ≥6 units of pRBC within 4 h of presentation were included. Patient demographics, admission labs and outcomes were obtained. Univariate and multiple logistic regression analyses were performed.

Results: 562 patients were identified. There were no significant differences in demographics, admission labs, or outcome between different ABO groups. After adjustment, Type A patients were more likely to be hypocoagulable compared to Type O patients (p = 0.014). No mortality differences were seen between ABO types in multiple regression analysis.

Conclusions: No outcome or mortality differences were seen between ABO types, therefore factors other than vWF expression should be considered to explain coagulopathy in trauma patients.

Keywords: ABO blood-group system; Coagulopathy; Hemorrhage; Trauma; von Willebrand factor.