Gender-based differences in mortality in response to high product ratio massive transfusion.
J Trauma
; 71(2 Suppl 3): S375-9, 2011 Aug.
Article
em En
| MEDLINE
| ID: mdl-21814107
ABSTRACT
BACKGROUND:
Recent data suggest that patients undergoing massive transfusion have lower mortality rates when ratios of plasma and platelets to red blood cells (RBCs) of ≥ 12 are used. This has not been examined independently in women and men. A gender dichotomy in outcome after severe injury is known to exist. This study examined gender-related differences in mortality after high product ratio massive transfusion.METHODS:
A retrospective study was conducted using a database containing massively transfused trauma patients from 23 Level I trauma centers. Baseline demographic, physiologic, and biochemical data were obtained. Univariate and logistic regression analyses were performed. Adjusted mortality in patients receiving high (≥ 12) or low (<12) ratios of plasma or platelets to RBCs was compared in women and men independently.RESULTS:
Seven hundred four patients were analyzed. In males, mortality was lower for patients receiving a high plasmaRBC ratio at 24 hours (20.6% vs. 33.0% for low ratio, p = 0.005) and at 30 days (34.9% vs. 42.8%, p = 0.032). Males receiving a high plateletRBC ratio also had lower 24-hour mortality (17.6% vs. 31.5%, p = 0.004) and 30-day mortality (32.1% vs. 42.2%, p = 0.045). Females receiving high ratios of plasma or platelets to RBCs had no improvement in 24-hour mortality (p = 0.119 and 0.329, respectively) or 30-day mortality (p = 0.199 and 0.911, respectively). Use of high product ratio transfusions did not affect 24-hour RBC requirements in males or females.CONCLUSION:
Use of high plasmaRBC or plateletRBC ratios in massive transfusion may benefit men more than women. This may be due to gender-related differences in coagulability. Further study is needed to determine whether separate protocols for women and men should be established.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ferimentos e Lesões
/
Transfusão de Sangue
/
Hemorragia
Tipo de estudo:
Observational_studies
Limite:
Adult
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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