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2136 The association of ABO and Rh blood groups with 30-day mortality following traumatic injury – a retrospective observational study
  1. Jane Li1,
  2. Rachel Bell1,
  3. Ed Barnard2,
  4. Liam Barrett2,
  5. Bushry Basheer1,
  6. Jacques Bowman3,
  7. Adrian Boyle2
  1. 1University of Cambridge
  2. 2Cambridge University Hospitals
  3. 3Cambridge University Hospitals Trauma Service


Aims and Objectives Trauma is a leading cause of death for those under 44. Patients with blood group O (bgO) have been reported to have higher mortality. The existing hypothesis (that lower levels of circulating von Willebrand factor/factor VIII in patients with bgO increases mortality through a bleeding tendency) has not been tested. Our study uniquely investigates the association between all ABO Rh groups and 30-day all-cause mortality in a large adult trauma patient cohort. Understanding post-trauma physiological shifts may identify potential therapeutic targets to attenuate risks.

Method and Design All patients ≥16 years old attending the East of England Major Trauma Centre (2016-2019) who met Trauma Audit Research Network (TARN) criteria were included. The primary outcome was 30-day mortality; secondary outcomes included admission clotting profile (PT/aPTT). Data reported as number (percentage), median [interquartile range]. Proportions were compared with a Chi-square test, reported as relative risk (95% confidence interval) (RR (95%CI)). Continuous data were compared with a Kruskal-Wallis test, reported as p-value. Data analyses were performed in Python v.3.8.9. Bonferroni correction was used for multiple comparisons.

Results and Conclusion 4188 patients were included. The median age was 59.3 [39.0-77.9] years, n=2634 (62.9%) were male, the median injury severity score was 19 [10-25], and 30-day mortality was 9.3%. Pairwise comparison demonstrated increased mortality in O Rh negative patients (Oneg) compared to three other groups, table 1. Compared to all other ABO Rh groups combined, Oneg patients had significantly greater 30-day mortality – 15.1% compared to 8.8%; RR 1.72 (95%CI 1.32-2.24), p=0.0002 (significance defined as p<0.0063 (eight comparisons)). There was no difference in admission PT or aPTT between Oneg and all other groups combined, p=0.12 and p=0.26 respectively. Trauma patients with Oneg had significantly greater 30-day mortality compared to other ABO Rh groups, which questions the existing hypothesis of the underlying mechanism.

Abstract 2136 Table 1

A pairwise comparison of 30-day mortality between all ABO Rh blood groups in n=4188 trauma patients at the East of England Major Trauma Centre (2016-2019)

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