Outcomes after massive transfusion in nontrauma patients in the era of damage control resuscitation.

Journal Article (Journal Article)

There are little data regarding the use of massive transfusion protocols (MTP) outside of the trauma setting. This study compares the use of an MTP between trauma and non-trauma (NT) patients. Data were collected for trauma and NT patients from the prospectively maintained MTP database at a Level I trauma center over a 4-year period. Massive transfusion was defined as ≥ 10 units packed red blood cells (PRBCs) in a 24-hour period. Of 439 MTP activations, 37 (8%) were NT patients (64% male; mean age = 51 years, initial base deficit = -10.8). Activations were for gastrointestinal bleeding (n = 18), bleeding during surgery (n = 13), obstetrical complications (n = 5), and ruptured aortic aneurysm (n = 1). Over-activation of MTP (<10 units PRBCs/24 hours) was higher in NT than trauma patients (19/37, 51% vs 118/284, 29%, P < 0.01). For massive transfusion patients, 24-hour mortality was higher in NT compared with trauma patients (10/17, 59% vs 100/284, 35%, P = 0.05), but there was no difference in 30-day mortality (10/17, 59% vs 144/284, 51%, P = 0.51). With over-activation in 51% of NT patients, MTP usage outside of trauma is inefficient. Outcomes in NT patients were worse than trauma patients, which may be related to the underlying disease processes.

Full Text

Duke Authors

Cited Authors

  • Morse, BC; Dente, CJ; Hodgman, EI; Shaz, BH; Winkler, A; Nicholas, JM; Wyrzykowski, AD; Rozycki, GS; Feliciano, DV

Published Date

  • June 2012

Published In

Volume / Issue

  • 78 / 6

Start / End Page

  • 679 - 684

PubMed ID

  • 22643264

Pubmed Central ID

  • 22643264

Electronic International Standard Serial Number (EISSN)

  • 1555-9823

Language

  • eng

Conference Location

  • United States