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High transfusion ratios are not associated with increased complication rates in patients with severe extremity injuries.
J Trauma. 2010 Jul; 69 Suppl 1:S64-8.JT

Abstract

BACKGROUND

High transfusion ratios of plasma to packed red blood cells (>1:2) have been associated with increased survival and increased complications in patients receiving massive transfusion (MT). We hypothesized that high ratio transfusion would be associated with no survival benefit and increased complications in combat victims with compressible hemorrhage.

METHODS

A retrospective analysis of soldiers injured in the current conflict during 5 years (n = 2,105) who received blood was performed on those with isolated extremity (abbreviated injury scale extremity score > or = 3 and abbreviated injury scale score 0-2 in all other regions) injury comparing those who received a MT with those who did not. Transfusion ratios in the first 24 hours were correlated with outcomes.

RESULTS

Injury severity score (14.6 vs. 12.1; p < 0.05), international normalized ratio (1.65 vs. 1.28; p < 0.05), and base deficit (8.0 vs. 3.7; p < 0.05) were higher in the MT group. High transfusion ratios were associated with a trend toward decreased mortality (17.2% vs. 6.9%; p = 0.07) in MT patients and no increased complications (20.7% vs. 26.4%; p > 0.05). In those receiving a non-MT, high ratios were associated with similar mortality (4.8% vs. 3.9%; p > 0.05) and complications (12.4% vs. 9.2%; p > 0.05).

CONCLUSIONS

Extremity injured patients receiving MT may benefit from high transfusion ratios and do not experience increased complications. No change in mortality or complications was observed in non-MT patients across transfusions ratios. High transfusion ratios are not associated with increased complications in patients with isolated extremity injury regardless of whether a MT is required.

Authors+Show Affiliations

Division of Trauma, Critical Care, and Acute Care Surgery, Oregon Health & Science University, Portland, Oregon 97239-3098, USA.No 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

20622622

Citation

Van, Philbert Y., et al. "High Transfusion Ratios Are Not Associated With Increased Complication Rates in Patients With Severe Extremity Injuries." The Journal of Trauma, vol. 69 Suppl 1, 2010, pp. S64-8.
Van PY, Sambasivan CN, Wade CE, et al. High transfusion ratios are not associated with increased complication rates in patients with severe extremity injuries. J Trauma. 2010;69 Suppl 1:S64-8.
Van, P. Y., Sambasivan, C. N., Wade, C. E., Jones, J. A., Holcomb, J. B., Schreiber, M. A., & Blackbourne, L. H. (2010). High transfusion ratios are not associated with increased complication rates in patients with severe extremity injuries. The Journal of Trauma, 69 Suppl 1, S64-8. https://doi.org/10.1097/TA.0b013e3181e453ec
Van PY, et al. High Transfusion Ratios Are Not Associated With Increased Complication Rates in Patients With Severe Extremity Injuries. J Trauma. 2010;69 Suppl 1:S64-8. PubMed PMID: 20622622.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High transfusion ratios are not associated with increased complication rates in patients with severe extremity injuries. AU - Van,Philbert Y, AU - Sambasivan,Chitra N, AU - Wade,Charles E, AU - Jones,John A, AU - Holcomb,John B, AU - Schreiber,Martin A, AU - Blackbourne,Lorne H, PY - 2010/7/13/entrez PY - 2010/8/5/pubmed PY - 2010/9/30/medline SP - S64 EP - 8 JF - The Journal of trauma JO - J Trauma VL - 69 Suppl 1 N2 - BACKGROUND: High transfusion ratios of plasma to packed red blood cells (>1:2) have been associated with increased survival and increased complications in patients receiving massive transfusion (MT). We hypothesized that high ratio transfusion would be associated with no survival benefit and increased complications in combat victims with compressible hemorrhage. METHODS: A retrospective analysis of soldiers injured in the current conflict during 5 years (n = 2,105) who received blood was performed on those with isolated extremity (abbreviated injury scale extremity score > or = 3 and abbreviated injury scale score 0-2 in all other regions) injury comparing those who received a MT with those who did not. Transfusion ratios in the first 24 hours were correlated with outcomes. RESULTS: Injury severity score (14.6 vs. 12.1; p < 0.05), international normalized ratio (1.65 vs. 1.28; p < 0.05), and base deficit (8.0 vs. 3.7; p < 0.05) were higher in the MT group. High transfusion ratios were associated with a trend toward decreased mortality (17.2% vs. 6.9%; p = 0.07) in MT patients and no increased complications (20.7% vs. 26.4%; p > 0.05). In those receiving a non-MT, high ratios were associated with similar mortality (4.8% vs. 3.9%; p > 0.05) and complications (12.4% vs. 9.2%; p > 0.05). CONCLUSIONS: Extremity injured patients receiving MT may benefit from high transfusion ratios and do not experience increased complications. No change in mortality or complications was observed in non-MT patients across transfusions ratios. High transfusion ratios are not associated with increased complications in patients with isolated extremity injury regardless of whether a MT is required. SN - 1529-8809 UR - https://www.unboundmedicine.com/medline/citation/20622622/High_transfusion_ratios_are_not_associated_with_increased_complication_rates_in_patients_with_severe_extremity_injuries_ L2 - https://doi.org/10.1097/TA.0b013e3181e453ec DB - PRIME DP - Unbound Medicine ER -