2.50
Hdl Handle:
http://hdl.handle.net/10755/162862
Type:
Presentation
Title:
Variables Affecting Trauma Patient Outcome Following Massive Transfusion
Abstract:
Variables Affecting Trauma Patient Outcome Following Massive Transfusion
Conference Sponsor:Emergency Nurses Association
Conference Year:2003
Author:Criddle, Laura M., MS, RN, CEN
P.I. Institution Name:Oregon Health and Science University
Contact Address:28384 Hafferman Road, Scappoose, OR, 97056, USA
Contact Telephone:503/494-1350
Co-Authors:Jeffry Walker, BSN, RN, CEN; and Deborah Eldredge, PhD, RN
Purpose: This study was designed to identify variables contributing to survival following massive blood transfusion (MBT) among major trauma patients. Although injured patients frequently receive huge volumes of donor blood, the literature contains: 1) no consistent definition of MBT; 2) minimal data regarding outcomes following MBT; and 3) little information about variables (patient or transfusion-related factors) associated with survival. Design: A retrospective, descriptive, correlational design was used. Setting: This study was conducted at a single Level 1 academic trauma center. Sample: The institution's Trauma Registry flags all patients who receive >10 units of packed red blood cells (PRBC) during their hospitalization. In 1993-2001, there were 13,005 trauma patients treated. 227 subjects were preliminarily identified. This included all age groups, genders, and mechanisms of injury. Methodology: Variables derived from the Trauma Registry included age, gender, mechanism of injury, Injury Severity Score, and survival status. The facility's Blood Bank database was accessed to determine the actual number of units of PRBC, fresh frozen plasma (FFP), platelets, and cryoprecipitate transfused and the administration timeframe. The volume of each product given was categorized as: 1) within 24 hours of injury; 2) between 24-48 hours of injury; and 3) during the remaining hospital stay. Data were analyzed using a multivariate logistic regression model. Results: The final model was significant (p < .001) and predicted survival correctly 79% of the time. Controlling for all other variables, persons with blunt injuries were considerably more likely to die (odds ratio = 2.5). In the first 24 hours post-injury, for each additional PRBC unit transfused, patients were 1.1 times more likely to die. However, with each additional FFP unit, patients were less likely (91%) to die. Between 24-48 hours PRBC (.73) and cryoprecipitate (1.2) volumes predicted survival. During the remainder of the hospital stay PRBC (.88) and FFP (1.2) administration was predictive of survival. There were two high risk patient groups: those who received >100 units of blood in the first 24 hours and those over age 55 who received >50 units in the first 24 hours. Both groups had 50% survival rates.
Conclusions: Although mortality increases with transfusion volume, MBT's relationship to survival is not consistent over the course of hospitalization and varies by type of product and time of administration. Even after huge amounts transfused, the probability of survival remains good. This data does not justify the practice of assigning predetermined limits to transfusion volumes in the trauma patient population. [Research Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleVariables Affecting Trauma Patient Outcome Following Massive Transfusionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162862-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Variables Affecting Trauma Patient Outcome Following Massive Transfusion</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Criddle, Laura M., MS, RN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health and Science University</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">28384 Hafferman Road, Scappoose, OR, 97056, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">503/494-1350</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">criddlel@ohsu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Jeffry Walker, BSN, RN, CEN; and Deborah Eldredge, PhD, RN</td></tr><tr><td colspan="2" class="item-abstract">Purpose: This study was designed to identify variables contributing to survival following massive blood transfusion (MBT) among major trauma patients. Although injured patients frequently receive huge volumes of donor blood, the literature contains: 1) no consistent definition of MBT; 2) minimal data regarding outcomes following MBT; and 3) little information about variables (patient or transfusion-related factors) associated with survival. Design: A retrospective, descriptive, correlational design was used. Setting: This study was conducted at a single Level 1 academic trauma center. Sample: The institution's Trauma Registry flags all patients who receive &gt;10 units of packed red blood cells (PRBC) during their hospitalization. In 1993-2001, there were 13,005 trauma patients treated. 227 subjects were preliminarily identified. This included all age groups, genders, and mechanisms of injury. Methodology: Variables derived from the Trauma Registry included age, gender, mechanism of injury, Injury Severity Score, and survival status. The facility's Blood Bank database was accessed to determine the actual number of units of PRBC, fresh frozen plasma (FFP), platelets, and cryoprecipitate transfused and the administration timeframe. The volume of each product given was categorized as: 1) within 24 hours of injury; 2) between 24-48 hours of injury; and 3) during the remaining hospital stay. Data were analyzed using a multivariate logistic regression model. Results: The final model was significant (p &lt; .001) and predicted survival correctly 79% of the time. Controlling for all other variables, persons with blunt injuries were considerably more likely to die (odds ratio = 2.5). In the first 24 hours post-injury, for each additional PRBC unit transfused, patients were 1.1 times more likely to die. However, with each additional FFP unit, patients were less likely (91%) to die. Between 24-48 hours PRBC (.73) and cryoprecipitate (1.2) volumes predicted survival. During the remainder of the hospital stay PRBC (.88) and FFP (1.2) administration was predictive of survival. There were two high risk patient groups: those who received &gt;100 units of blood in the first 24 hours and those over age 55 who received &gt;50 units in the first 24 hours. Both groups had 50% survival rates. <br/>Conclusions: Although mortality increases with transfusion volume, MBT's relationship to survival is not consistent over the course of hospitalization and varies by type of product and time of administration. Even after huge amounts transfused, the probability of survival remains good. This data does not justify the practice of assigning predetermined limits to transfusion volumes in the trauma patient population. [Research Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:35:25Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:35:25Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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