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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The impact of platelet transfusion in massively transfused trauma patients
Journal of the American College of Surgeons, Volume 211, No. 5, Year 2010
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Description
Background The impact of platelet transfusion in trauma patients undergoing a massive transfusion (MT) was evaluated. Study Design The Institutional Trauma Registry and Blood Bank Database at a Level I trauma center was used to identify all patients requiring an MT (≥10 packed red blood cells [PRBC] within 24 hours of admission). Mortality was evaluated according to 4 apheresis platelet (aPLT):PRBC ratios: Low ratio (<1:18), medium ratio (≥1:18 and <1:12), high ratio (≥1:12 and <1:6), and highest ratio (≥1:6). Results Of 32,289 trauma patients, a total of 657 (2.0%) required an MT. At 24 hours, 171 patients (26.0%) received a low ratio, 77 (11.7%) a medium ratio, 249 (37.9%) a high ratio, and 160 (24.4%) the highest ratio of aPLT:PRBC. After correcting for differences between groups, the mortality at 24 hours increased in a stepwise fashion with decreasing aPLT:PRBC ratio. Using the highest ratio group as a reference, the adjusted relative risk of death was 1.67 (adjusted p = 0.054) for the high ratio group, 2.28 (adjusted p = 0.013) for the medium ratio group, and 5.51 (adjusted p < 0.001) for the low ratio group. A similar stepwise increase in mortality with decreasing platelet ratio was observed at 12 hours after admission and for overall survival to discharge. After stepwise logistic regression, a high aPLT:PRBC ratio (adjusted p < 0.001) was independently associated with improved survival at 24 hours. Conclusions For injured patients requiring a massive transfusion, as the apheresis platelet-to-red cell ratio increased, a stepwise improvement in survival was seen. Prospective evaluation of the role of platelet transfusion in massively transfused patients is warranted. © 2010 American College of Surgeons.
Authors & Co-Authors
Inaba, Kenji
United States, Los Angeles
Los Angeles County Usc Medical Center
Holcomb, John Bradley B.
United States, Houston
University of Texas Medical School at Houston
Talving, Peep
United States, Los Angeles
Los Angeles County Usc Medical Center
Demetriades, Demetrios G.
United States, Los Angeles
Los Angeles County Usc Medical Center
Statistics
Citations: 95
Authors: 4
Affiliations: 4
Identifiers
Doi:
10.1016/j.jamcollsurg.2010.06.392
ISSN:
10727515
Study Design
Cohort Study