1561: Mortality following High Blood Product Transfusion among Severely Injured Trauma Patients.

Crit Care Med 2016 • Volume 44 • Number 12 (Suppl.) 81 adult patients admitted to the ICU of a Level I trauma center for ≥48 hours. Subjects were screened for posttraumatic stress symptoms during hospitalization, and 3, 6, and 12 months later. BU was converted to lorazepam equivalents and dosage subgroups were created. Patient characteristics were compared using t-tests, Wilcoxon rank sum tests, or chi-square tests, as appropriate. Patient outcomes were evaluated using multiple regression analysis. Results: Forty-six patients (56.8%) received benzodiazepines in the ICU. These patients were significantly more likely to endorse pre-morbid PTSD, have higher injury severity score (ISS), be on the ventilator longer, and have positive toxicology screen. There was no significant difference between dosage subgroups in rates of PTSD for any BU, intermittent administration, or higher overall benzodiazepine exposure. However, of the 19 patients who received continuous benzodiazepines, 5 (26.3%) screened positive for PTSD at 3 months (p=0.048), after controlling for ISS. Those patients also had significantly higher pre-injury BU (p=0.006). Conclusions: This study did not show a correlation between BU in the trauma ICU and later PTSD, a finding inconsistent with current literature suggesting a relationship in this population. A small subset of patients who received continuous benzodiazepines had PTSD at 3 months, though not on subsequent evaluations. Concurrent opiate use in the majority of our trauma ICU patients may have confounded our ability to detect a causal relationship between BU and PTSD. Further investigation is warranted.