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Critical care
Impact of blood group on survival following critical illness: a single-centre retrospective observational study
  1. Robert Slade1,
  2. Raza Alikhan2,
  3. Matt P Wise1,
  4. Lam Germain1,
  5. Simon Stanworth3 and
  6. Matt Morgan1
  1. 1 Adult Critical Care, University Hospital of Wales, Cardiff and Vale University Healthcare NHS Trust, Cardiff, UK
  2. 2 Department of Haematology, University Hospital of Wales, Cardiff and Vale University Healthcare NHS Trust, Cardiff, UK
  3. 3 Departement of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  1. Correspondence to Dr Matt Morgan; mattmorgan{at}me.com

Abstract

Background Predicting patient outcomes following critical illness is challenging. Recent evidence has suggested that patients with blood group AB are more likely to survive following major cardiac surgery, and this is associated with a reduced number of blood transfusions. However, there are no current data to indicate whether a patient’s blood group affects general intensive care outcomes.

Objective The objective of this study was to determine if ABO blood group affects survival in intensive care. The primary outcome measure was 90-day mortality with a secondary outcome measure of the percentage of patients receiving a blood transfusion.

Design Retrospective analysis of electronically collected intensive care data, blood group and transfusion data.

Setting General intensive care unit (ICU) of a major tertiary hospital with both medical and surgical patients.

Patients All patients admitted to ICU between 2006 and 2016 who had blood group data available.

Intervention None.

Measurements and main results 7340 patients were included in the study, blood group AB accounted for 3% (221), A 41% (3008), B 10.6% (775) and O 45.4% (3336). These values are similar to UK averages. Baseline characteristics between the groups were similar. Blood group AB had the greatest survival benefit (blood group AB 90-day survival estimate 76.75, 95% CI 72.89 to 80.61 with the overall estimate 72.07, 95% CI 71.31 to 72.82) (log-rank χ2 16.128, p=0.001). Transfusion requirements were similar in all groups with no significant difference between the percentages of patients transfused (AB 23.1%, A 21.5%, B 18.7%, O 19.9%, Pearson χ2 5.060 p=0.167).

Conclusion Although this is primarily a hypothesis generating study, intensive care patients with blood group AB appeared to have a higher 90-day survival compared with other blood groups. There was no correlation between blood group and percentage of patients receiving transfusion.

  • blood group
  • ICU
  • survival benefit

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjresp-2019-000426

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    Footnotes

    • Contributors MM and RS conceived of the presented idea and developed the theory. LG and RD collected the data. RS performed many of the computations. RA, MPW and SS verified the analytical methods. All authors discussed the results and contributed to the final manuscript.

    • Funding Study carried out at the University Hospital of Wales Critical Care Directorate.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Welsh Research Ethics Committee reference 16/WA/0207.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request.