Massive Blood Transfusions and Outcomes in Trauma Patients; An Intention to Treat Analysis
Journal Title: Bulletin of Emergency And Trauma - Year 2018, Vol 6, Issue 3
Abstract
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.
Authors and Affiliations
Steven Liu, Quinn Fujii, Farris Serio, Andrew McCague
Determinants of the Lethal Area 50 Index (LA50) in Burn Patients Admitted to a Tertiary Referral Burn Center in Southern Iran
Objective: To evaluate the lethal area 50 (LA50) and determinants of mortality in burn patients admitted to a single burn center. Methods: This retrospective cross-sectional study was conducted in a tertiary burn center...
Efficacy and Safety of Morphine and Low Dose Ketamine for Pain Control of Patients with Long Bone Fractures: A Randomized, Double-Blind, Clinical Trial
Objective: To compare the effects of intravenous morphine and a low dose of ketamine on pain intensity of patients with traumatic fractures of the long bones. Methods: This randomized, controlled, double-blinded, clinica...
Diaphragmatic Herniation of Ruptured Right Lobe of Liver with Hypertrophied Left Lobe
A 17-year-girl presented with recurrent pain in abdomen of 10-year duration. The pain used to start as dull ache on right side of her abdomen, which gradually would increase over few hours to become moderately severe. Th...
Healing Effects of Dried and Acellular Human Amniotic Membrane and Mepitelas for Coverage of Skin Graft Donor Areas; A Randomized Clinical Trial
Objective: To compare the healing effects of dried and acellular human amniotic membrane and Mepitel for coverage of split-thickness graft donor site (STGDS). Methods: Twenty patients who underwent STGDS regeneration s...
Correlation between Success Rates of Cardiopulmonary Cerebral Resuscitation and the Educational Level of the Team Leader; A Cross-Sectional Study
Objectives: To determine the correlation between the success rates of the cardiopulmonary cerebral resuscitation (CPCR) and the team’s leader education and skill level in Shiraz, southern Iran. Method: This cross-section...