Retrospective evaluation of admission total plasma protein as a predictor of red blood cell transfusion requirement in dogs diagnosed with traumatic and nontraumatic hemoabdomen: 90 dogs (2009-2019).

Abstract

To evaluate the association of admission total plasma protein (TPP) and the administration of red blood cell transfusions in dogs with diagnosed hemoabdomen. To secondarily evaluate additional point-of-care parameters associated with red blood cell transfusion administration. Retrospective study between 2009 and 2019. University veterinary teaching hospital. Ninety dogs admitted to a university veterinary teaching hospital after a diagnosis of traumatic or nontraumatic hemoabdomen (NTH). Medical records were retrospectively reviewed; signalment, point-of-care diagnostics, and transfusion administration information was recorded.A total of 47 dogs (traumatic hemoabdomen 11/26; NTH 36/64) received packed red blood cell transfusions. For each 1g/dL unit decrease in TPP, dogs had an increased odds ratio (OR) of 2.14 (95% confidence interval [CI]: 1.44-3.40, P<0.001) of receiving a red blood cell transfusion. Dogs diagnosed with NTH were more likely to receive a red blood cell transfusion than dogs with a traumatic hemoabdomen (OR: 2.78, 95% CI: 1.11-7.141, P=0.03). Lower PCV values (OR: 1.08, 95% CI: 1.04-1.12, P<0.001), bicarbonate values (OR: 1.3, 95% CI: 1.09-1.56, P=0.003), and base excess (OR: 1.27, 95% CI: 1.1-1.49, P=0.003) were associated with a higher likelihood of red blood cell transfusion. Additionally, higher lactate (OR: 1.35, 95% CI: 1.16-1.63, P<0.001) and Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast scores (OR: 1.10, 95% CI: 1.04-1.17, P<0.001) were associated with increased red blood cell transfusion administration. Low admission TPP, independent of low PCV, was associated with red blood cell transfusions regardless of underlying cause. For each 1g/dL unit decrease in TPP on presentation, dogs were approximately 2 times more likely to receive a red blood cell transfusion during hospitalization. Other factors that were associated with increased transfusion administration included presenting PCV, PCV/TPP ratio, bicarbonate, base excess, lactate, and APPLEfast scores.