The association of blood component use ratios with the survival of massively transfused trauma patients with and without severe brain injury.
J Trauma
; 71(2 Suppl 3): S343-52, 2011 08.
Article
em En
| MEDLINE
| ID: mdl-21814102
ABSTRACT
BACKGROUND:
The effect of blood component ratios on the survival of patients with traumatic brain injury (TBI) has not been studied.METHODS:
A database of patients transfused in the first 24 hours after admission for injury from 22 Level I trauma centers over an 18-month period was queried to find patients who (1) met different definitions of massive transfusion (5 units red blood cell [RBC] in 6 hours vs. 10 units RBC in 24 hours), (2) received high or low ratios of platelets or plasma to RBC units (<12 vs. ≥ 12), and (3) had severe TBI (head abbreviated injury score ≥ 3) (TBI+).RESULTS:
Of 2,312 total patients, 850 patients were transfused with ≥ 5 RBC units in 6 hours and 807 could be classified into TBI+ (n = 281) or TBI- (n = 526). Six hundred forty-three patients were transfused with ≥ 10 RBC units in 24 hours with 622 classified into TBI+ (n = 220) and TBI- (n = 402). For both high-risk populations, a high ratio of plateletsRBCs (not plasma) was independently associated with improved 30-day survival for patients with TBI+ and a high ratio of plasmaRBCs (not platelets) was independently associated with improved 30-day survival in TBI- patients.CONCLUSIONS:
High platelet ratio was associated with improved survival in TBI+ patients while a high plasma ratio was associated with improved survival in TBI- patients. Prospective studies of blood product ratios should include TBI in the analysis for determination of optimal use of ratios on outcome in injured patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Lesões Encefálicas
/
Transfusão de Componentes Sanguíneos
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Trauma
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Estados Unidos