TY  - JOUR
T1  - IMproved survival following massive transfusion in patients who have undergone trauma
AU  - Cinat ME, Wallace WC, Nastanski F, et al
Y1  - 1999/09/01
N1  - 10.1001/archsurg.134.9.964
JO  - Archives of Surgery
SP  - 964
EP  - 968
VL  - 134
IS  - 9
N2  - Hypothesis 
    Survival following massive transfusion in patients who have undergone trauma has improved during the past 10 years.Design 
    Retrospective cohort study.Setting 
    Academic level I trauma center in an urban community.Patients 
    All patients who underwent trauma and who received greater than 50 U of packed red blood cells or whole blood in the 48 hours following admission to the emergency department.Interventions 
    Data were obtained from blood bank records, the trauma registry, patient medical records, and hospital purchasing records. Patients were divided into 2 groups for comparison (early [1988-1992] and late [1993-1997] periods).Main Outcome Measures 
    Survival and changes in trauma care provision.Results 
    Survival following massive transfusion in patients who have undergone trauma has significantly increased during the past 10 years (16% vs 45%, early vs late period, P=.03). Factors associated with poor outcome included male sex, major vascular injury, high Injury Severity Score, severe acidosis, prolonged hypotension, refractory hypothermia, and decreased use of platelet transfusion (all P<.05). In the later period, there was more aggressive correction of coagulopathy, more efficient use of warming measures, decreased operative times for the initial operation, and increased use of component therapy (all P<.05).Conclusions 
    Survival following massive transfusion has significantly (P=.03) increased during the past 10 years. Factors that may have contributed to this include more effective and efficient rewarming procedures, improved application of damage control techniques, more aggressive correction of coagulopathy, and improved blood banking procedures.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.134.9.964
UR  - http://dx.doi.org/10.1001/archsurg.134.9.964
ER  -