Traumatically injured women are significantly less likely to receive whole blood transfusions within the first four hours of injury compared to men, despite the fact that whole blood has been linked to reduced mortality in both women and men, according to a recent study conducted by researchers at the University of Pittsburgh School of Medicine.
The study, which was recently published in the journal Transfusion, highlights the urgent need to address the underlying reasons for the gender disparity in providing whole blood transfusions to individuals in need of life-saving treatment. Lead author Skye Clayton, a clinical research coordinator at Pitt’s Trauma and Transfusion Medicine Research Center, expressed disappointment at the disparities observed in the study.
The research team analyzed data from almost 41,000 females and 116,000 males who had suffered traumatic injuries and received at least one liter of low-titer O whole blood within the first four hours of hospital admission. Low-titer O whole blood is donated by individuals with type O blood and has low levels of antibodies against type A or B blood.
The study found that females under 50 years of age were 40% less likely to receive low-titer O whole blood compared to males of similar age, while females over 50 years of age were 20% less likely to receive it than their male counterparts. The researchers also noted that the use of whole blood was associated with better outcomes in both men and women, with a 20% to 25% reduced risk of mortality.
Despite the benefits of whole blood transfusions, the study revealed that younger women and girls were less likely to receive them due to concerns about potential future pregnancies. The majority of low-titer O whole blood available for trauma resuscitation is positive for the RhD antigen, which can lead to complications in future pregnancies if a woman develops antibodies against it.
However, the risk of fetal death as a result of RhD-positive blood transfusions is very low, and can be effectively managed with modern treatments during pregnancy. Dr. Philip Spinella, the senior author of the study, emphasized the importance of prioritizing life-saving treatments over theoretical risks to future pregnancies.
Another study published in Transfusion, led by Dr. Mark Yazer and his colleagues, focused on females of childbearing potential between the ages of 15 and 50. The study found that males were nearly twice as likely to receive low-titer O whole blood compared to females in this age group.
The researchers suggested that the transfusion community needs to reevaluate the risk-benefit ratio of providing RhD-positive low-titer O whole blood to traumatically injured women, especially when RhD-negative blood is not available. By increasing awareness of the low risk and implementing modern treatments, more lives can be saved.
Overall, the studies underscore the importance of addressing gender disparities in trauma care and ensuring equitable access to life-saving treatments for all individuals, regardless of gender. The findings highlight the need for continued research and education to improve trauma resuscitation practices and reduce preventable deaths due to blood loss.
