Massive Blood Transfusions and Outcomes in Trauma Patients; An Intention to Treat Analysis

• Main Authors: Steven Liu, Quinn Fujii, Farris Serio, Andrew McCague
• Format: Article
• Language: English
• Published: Shiraz University of Medical Sciences 2018-07-01
• Series: Bulletin of Emergency and Trauma
• Subjects: Massive transfusion; Blood transfusion; Trauma; Blood loss
• Online Access: http://beat.sums.ac.ir/article_44437_928bba90105fffeaaa676a9df49a1b48.pdf

Objective: To determine if there exists an upper limit for amount of blood transfused in trauma patients before it reaches a point of futility.Methods: A prospective cohort study was conducted on 131 patients who received massive blood transfusion (MBT), defined as 10 U or higher of PRBCs received in the initial 24 hours. Data collected from a Level II trauma center registry were used to analyze reports of adult patients from July 2014 to 2017. Cohorts were divided by amount of blood received - 0 to 9 U, 10-19 U, 20 to 29 U, 30-39 U, 40 U or higher - odds ratio for mortality and p-values for mean Injury Severity Score and overall hospital length of stay were calculated for each group.Results: Odds ratios for massive blood transfusion groups from 10 units to 39 units each contained the null value, while our 40 units and above group did not (OR 12.52, 95% CI 1.3-117.7).Conclusion: Although this study is limited by its sample size, these results suggests that 40 units of PRBCs may be a threshold at which survival rates begin to decrease significantly.