Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time

Persistent Link:
http://hdl.handle.net/10150/610337
Title:
Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time
Author:
Peralta, Ruben; Vijay, Adarsh; El-Menyar, Ayman; Consunji, Rafael; Abdelrahman, Husham; Parchani, Ashok; Afifi, Ibrahim; Zarour, Ahmad; Al-Thani, Hassan; Latifi, Rifat
Affiliation:
Trauma Surgery Section, Hamad Trauma Center, Hamad General Hospital; Clinical Research, Trauma Surgery Section, Hamad General Hospital; Clinical Medicine, Weill Cornell Medical College; Department of Surgery, University of Arizona
Issue Date:
2015
Publisher:
Springer
Citation:
Peralta et al. World Journal of Emergency Surgery (2015) 10:36 DOI 10.1186/s13017-015-0028-3
Journal:
World Journal of Emergency Surgery
Rights:
© 2015 Peralta et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
OBJECTIVE: We aimed to evaluate whether early administration of high plasma to red blood cells ratios influences outcomes in injured patients who received massive transfusion protocol (MTP). METHODS: A retrospective analysis was conducted at the only level 1 national trauma center in Qatar for all adult patients(≥18 years old) who received MTP (≥10 units) of packed red blood cell (PRBC) during the initial 24 h post traumatic injury. Data were analyzed with respect to FFB:PRBC ratio [(high ≥ 1:1.5) (HMTP) vs. (low < 1:1.5) (LMTP)] given at the first 4 h post-injury and also between (>4 and 24 h). Mortality, multiorgan failure (MOF) and infectious complications were studied as well. RESULTS: During the study period, a total of 4864 trauma patients were admitted to the hospital, 1.6 % (n = 77) of them met the inclusion criteria. Both groups were comparable with respect to initial pH, international normalized ratio, injury severity score, revised trauma score and development of infectious complications. However, HMTP was associated with lower crude mortality (41.9 vs. 78.3 %, p = 0.001) and lower rate of MOF (48.4 vs. 87.0 %, p = 0.001). The number of deaths was 3 times higher in LMTP in comparison to HMTP within the first 30 days (36 vs. 13 cases). The majority of deaths occurred within the first 24 h (80.5 % in LMTP and 69 % in HMTP) and particularly within the first 6 h (55 vs. 46 %). CONCLUSIONS: Aggressive attainment of high FFP/PRBC ratios as early as 4 h post-injury can substantially improve outcomes in trauma patients.
EISSN:
1749-7922
DOI:
10.1186/s13017-015-0028-3
Keywords:
Trauma; Transfusion ratio; Massive transfusion protocol; Outcome
Version:
Final published version
Additional Links:
http://www.wjes.org/content/10/1/36

Full metadata record

DC FieldValue Language
dc.contributor.authorPeralta, Rubenen
dc.contributor.authorVijay, Adarshen
dc.contributor.authorEl-Menyar, Aymanen
dc.contributor.authorConsunji, Rafaelen
dc.contributor.authorAbdelrahman, Hushamen
dc.contributor.authorParchani, Ashoken
dc.contributor.authorAfifi, Ibrahimen
dc.contributor.authorZarour, Ahmaden
dc.contributor.authorAl-Thani, Hassanen
dc.contributor.authorLatifi, Rifaten
dc.date.accessioned2016-05-20T09:04:34Z-
dc.date.available2016-05-20T09:04:34Z-
dc.date.issued2015en
dc.identifier.citationPeralta et al. World Journal of Emergency Surgery (2015) 10:36 DOI 10.1186/s13017-015-0028-3en
dc.identifier.doi10.1186/s13017-015-0028-3en
dc.identifier.urihttp://hdl.handle.net/10150/610337-
dc.description.abstractOBJECTIVE: We aimed to evaluate whether early administration of high plasma to red blood cells ratios influences outcomes in injured patients who received massive transfusion protocol (MTP). METHODS: A retrospective analysis was conducted at the only level 1 national trauma center in Qatar for all adult patients(≥18 years old) who received MTP (≥10 units) of packed red blood cell (PRBC) during the initial 24 h post traumatic injury. Data were analyzed with respect to FFB:PRBC ratio [(high ≥ 1:1.5) (HMTP) vs. (low < 1:1.5) (LMTP)] given at the first 4 h post-injury and also between (>4 and 24 h). Mortality, multiorgan failure (MOF) and infectious complications were studied as well. RESULTS: During the study period, a total of 4864 trauma patients were admitted to the hospital, 1.6 % (n = 77) of them met the inclusion criteria. Both groups were comparable with respect to initial pH, international normalized ratio, injury severity score, revised trauma score and development of infectious complications. However, HMTP was associated with lower crude mortality (41.9 vs. 78.3 %, p = 0.001) and lower rate of MOF (48.4 vs. 87.0 %, p = 0.001). The number of deaths was 3 times higher in LMTP in comparison to HMTP within the first 30 days (36 vs. 13 cases). The majority of deaths occurred within the first 24 h (80.5 % in LMTP and 69 % in HMTP) and particularly within the first 6 h (55 vs. 46 %). CONCLUSIONS: Aggressive attainment of high FFP/PRBC ratios as early as 4 h post-injury can substantially improve outcomes in trauma patients.en
dc.language.isoenen
dc.publisherSpringeren
dc.relation.urlhttp://www.wjes.org/content/10/1/36en
dc.rights© 2015 Peralta et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0)en
dc.subjectTraumaen
dc.subjectTransfusion ratioen
dc.subjectMassive transfusion protocolen
dc.subjectOutcomeen
dc.titleTrauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and timeen
dc.typeArticleen
dc.identifier.eissn1749-7922en
dc.contributor.departmentTrauma Surgery Section, Hamad Trauma Center, Hamad General Hospitalen
dc.contributor.departmentClinical Research, Trauma Surgery Section, Hamad General Hospitalen
dc.contributor.departmentClinical Medicine, Weill Cornell Medical Collegeen
dc.contributor.departmentDepartment of Surgery, University of Arizonaen
dc.identifier.journalWorld Journal of Emergency Surgeryen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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