Predictors of Blood Product Utilization (RBC, FFP, and Platelet) in Severe Burn Patients: A Single-Center Retrospective Study

Abstract

This single-center retrospective study aimed to identify predictors of any blood product transfusion—defined as the administration of one or more units of packed red blood cells (RBCs), fresh frozen plasma (FFP), or platelets—among adult patients with severe burns. In this cross-sectional study, 112 patients with burns that affected 20-50% of their total body surface area (TBSA) were analyzed. Demographic information, burn characteristics, and clinical outcomes were taken from medical records. Multivariate logistic regression was used to identify independent predictors. Transfusion indications during the study period followed institutional practice: RBC transfusion was generally considered for hemoglobin ≤7–8 g/dL or active bleeding; FFP was used for clinically significant coagulopathy or INR >1.5; and platelets were administered for counts <50×10⁹/L in surgical candidates. Blood product transfusion was administered to 46.4% of patients. The transfused group had significantly larger burns, higher rates of third-degree burns, more frequent inhalation injuries, and worse clinical outcomes, including higher rates of intensive care unit (ICU) admission (65.4% vs. 13.3%) and mortality (28.8% vs. 3.3%). Multivariate analysis revealed that third-degree burns (odds ratio (OR) = 5.98), the quantity of surgical procedures (OR = 1.80 per surgery), and the length of ICU stay (OR = 1.55 per day) serve as significant independent predictors of transfusion. Burn depth, surgical burden, and intensive care unit stay are key determinants of transfusion needs. These findings provide locally relevant evidence for transfusion management in severe burn patients, reflecting real-world practice patterns in our regional burn center. These findings support the development of risk-based protocols to optimize blood utilization and improve outcomes in severe burn patients.