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Red-blood-cell to plasma ratios transfused during massive transfusion are associated with mortality in severe multiple injury: a retrospective analysis from the Trauma Registry of the Deutsche Gesellschaft für Unfallchirurgie.
Vox Sang. 2008 Aug; 95(2):112-9.VS

Abstract

BACKGROUND

To test whether an acute transfusion practice of packed red blood cells (pRBC) : fresh-frozen plasma (FFP) 1 : 1 would be associated with reduced mortality in acute bleeding multiply injury.

METHODS

Retrospective analysis using the TR-DGU database (Trauma Registry of the Deutsche Gesellschaft für Unfallchirurgie 2002-2006) on primary admissions with substantial injury (Injury Severity Score > 16) and massive transfusion (> 10 pRBCs). Seven hundred thirteen patients were divided into three groups according to the pRBC : FFP ratio transfused, that is, (i) pRBC : FFP > 1.1; (ii) pRBC : FFP 0.9-1.1 (1 : 1); and (iii) pRBC : FFP < 0.9, and mortality rates were compared.

RESULTS

Four hundred ninety-seven (69.7%) of patients were male, the mean age was 40.1 (+/- 18.3) years. Injury characteristics and pathophysiological state upon emergency room arrival were comparable between groups. Out of 713, 484 patients had undergone massive transfusion with pRBC : FFP > 1.1, 114 with pRBC : FFP 0.9-1.1 (1 : 1), and 115 with pRBC : FFP < 0.9 ratios. Acute mortality (< 6 h) rates for pRBC : FFP > 1.1, pRBC : FFP 0.9-1.1 (1 : 1), and pRBC : FFP < 0.9 ratios were 24.6, 9.6 and 3.5% (P < 0.0001), 24-h mortality rates were 32.6, 16.7 and 11.3% (P < 0.0001), and 30-day mortality rates were 45.5, 35.1 and 24.3% (P < 0.001). The frequency for septic complications and organ failure was higher in the pRBC : FFP 0.9-1.1 (1 : 1) group, ventilator days and length of stays for intensive care unit and overall in-hospital were highest in the pRBC : FFP < 0.9 ratio group (P < 0.0005).

CONCLUSIONS

An association between pRBC : FFP transfusion ratios and mortality to favour early aggressive FFP administration was observed. Further investigation is necessary prior to recommending routine 1 : 1 or more aggressive FFP use in exsanguinating patients.

Authors+Show Affiliations

Department of Trauma and Orthopedic Surgery, and Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany. marc.maegele@t-online.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18557827

Citation

Maegele, M, et al. "Red-blood-cell to Plasma Ratios Transfused During Massive Transfusion Are Associated With Mortality in Severe Multiple Injury: a Retrospective Analysis From the Trauma Registry of the Deutsche Gesellschaft Für Unfallchirurgie." Vox Sanguinis, vol. 95, no. 2, 2008, pp. 112-9.
Maegele M, Lefering R, Paffrath T, et al. Red-blood-cell to plasma ratios transfused during massive transfusion are associated with mortality in severe multiple injury: a retrospective analysis from the Trauma Registry of the Deutsche Gesellschaft für Unfallchirurgie. Vox Sang. 2008;95(2):112-9.
Maegele, M., Lefering, R., Paffrath, T., Tjardes, T., Simanski, C., & Bouillon, B. (2008). Red-blood-cell to plasma ratios transfused during massive transfusion are associated with mortality in severe multiple injury: a retrospective analysis from the Trauma Registry of the Deutsche Gesellschaft für Unfallchirurgie. Vox Sanguinis, 95(2), 112-9. https://doi.org/10.1111/j.1423-0410.2008.01074.x
Maegele M, et al. Red-blood-cell to Plasma Ratios Transfused During Massive Transfusion Are Associated With Mortality in Severe Multiple Injury: a Retrospective Analysis From the Trauma Registry of the Deutsche Gesellschaft Für Unfallchirurgie. Vox Sang. 2008;95(2):112-9. PubMed PMID: 18557827.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Red-blood-cell to plasma ratios transfused during massive transfusion are associated with mortality in severe multiple injury: a retrospective analysis from the Trauma Registry of the Deutsche Gesellschaft für Unfallchirurgie. AU - Maegele,M, AU - Lefering,R, AU - Paffrath,T, AU - Tjardes,T, AU - Simanski,C, AU - Bouillon,B, AU - ,, Y1 - 2008/06/28/ PY - 2008/6/19/pubmed PY - 2008/10/9/medline PY - 2008/6/19/entrez SP - 112 EP - 9 JF - Vox sanguinis JO - Vox Sang VL - 95 IS - 2 N2 - BACKGROUND: To test whether an acute transfusion practice of packed red blood cells (pRBC) : fresh-frozen plasma (FFP) 1 : 1 would be associated with reduced mortality in acute bleeding multiply injury. METHODS: Retrospective analysis using the TR-DGU database (Trauma Registry of the Deutsche Gesellschaft für Unfallchirurgie 2002-2006) on primary admissions with substantial injury (Injury Severity Score > 16) and massive transfusion (> 10 pRBCs). Seven hundred thirteen patients were divided into three groups according to the pRBC : FFP ratio transfused, that is, (i) pRBC : FFP > 1.1; (ii) pRBC : FFP 0.9-1.1 (1 : 1); and (iii) pRBC : FFP < 0.9, and mortality rates were compared. RESULTS: Four hundred ninety-seven (69.7%) of patients were male, the mean age was 40.1 (+/- 18.3) years. Injury characteristics and pathophysiological state upon emergency room arrival were comparable between groups. Out of 713, 484 patients had undergone massive transfusion with pRBC : FFP > 1.1, 114 with pRBC : FFP 0.9-1.1 (1 : 1), and 115 with pRBC : FFP < 0.9 ratios. Acute mortality (< 6 h) rates for pRBC : FFP > 1.1, pRBC : FFP 0.9-1.1 (1 : 1), and pRBC : FFP < 0.9 ratios were 24.6, 9.6 and 3.5% (P < 0.0001), 24-h mortality rates were 32.6, 16.7 and 11.3% (P < 0.0001), and 30-day mortality rates were 45.5, 35.1 and 24.3% (P < 0.001). The frequency for septic complications and organ failure was higher in the pRBC : FFP 0.9-1.1 (1 : 1) group, ventilator days and length of stays for intensive care unit and overall in-hospital were highest in the pRBC : FFP < 0.9 ratio group (P < 0.0005). CONCLUSIONS: An association between pRBC : FFP transfusion ratios and mortality to favour early aggressive FFP administration was observed. Further investigation is necessary prior to recommending routine 1 : 1 or more aggressive FFP use in exsanguinating patients. SN - 1423-0410 UR - https://www.unboundmedicine.com/medline/citation/18557827/Red_blood_cell_to_plasma_ratios_transfused_during_massive_transfusion_are_associated_with_mortality_in_severe_multiple_injury:_a_retrospective_analysis_from_the_Trauma_Registry_of_the_Deutsche_Gesellschaft_für_Unfallchirurgie_ L2 - https://doi.org/10.1111/j.1423-0410.2008.01074.x DB - PRIME DP - Unbound Medicine ER -