Massive transfusion in pediatric trauma: analysis of the National Trauma Databank.
J Surg Res
; 208: 166-172, 2017 02.
Article
em En
| MEDLINE
| ID: mdl-27993204
ABSTRACT
BACKGROUND:
Massive transfusion (MT) in pediatric trauma has been described in combat populations and other single institutions studies. We aim to define the incidence of MT in a large US civilian pediatric trauma population, identify predictive parameters of MT, and the mortality associated with MT.METHODS:
Data from the National Trauma Databank (2010-2012), a trauma registry maintained by the American College of Surgeons, were analyzed. We included pediatric trauma patients ≤14 y that underwent MT, as defined by 40 mL/kg of blood products within the first 24 h after admission. We compared the MT group with children receiving any transfusion within the same time frame. Univariate and multivariate analysis were performed.RESULTS:
Of 356,583 pediatric trauma patients, 13,523 (4%) received any transfusion in the first 24 h and 173 (0.04%) had a MT. On multivariate analysis, factors predicting MT were older patients (5-12 OR 2.71, P = 0.006, and ≥12 OR 5.14, P < 0.001), hypothermic patients (temperature <35 OR 2.48, P < 0.025), low Glasgow Coma Scale (Glasgow Coma Scale <8 OR 2.82, P = 0.009), and Injury Severity Scores ≥25 (OR 2.01, P = 0.03). Overall mortality for the entire group, any transfusion group, and MT group were 2.5%, 13.6%, and 50.6%, respectively (P < 0.001).CONCLUSIONS:
MT in pediatric trauma is an uncommon event associated with a significant mortality. Patients undergoing MT are older, more likely to be hypothermic and have sustained more severe injuries as measured by traditional trauma scoring systems than transfused trauma patients.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ferimentos e Lesões
/
Transfusão de Sangue
Tipo de estudo:
Prognostic_studies
Limite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
J Surg Res
Ano de publicação:
2017
Tipo de documento:
Article