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Variables predicting trauma patient survival following massive transfusion
Laura M Criddle1, Deborah H Eldredge, Jeffery Walker
1School of Nursing, Oregon Health and Science University, 28384 Hafferman Rd, Scappoose, OR 97056, USA. criddlel@ohsu.edu
Journal of Emergency Nursing
|June 29, 2005
Summary
Massive blood transfusions in trauma patients show a 63% survival rate. Arterial base deficit, not blood volume, significantly predicts survival, indicating a need for better early indicators.
Area of Science:
- Trauma critical care
- Transfusion medicine
- Emergency medicine
Background:
- Limited data exists on factors influencing survival after massive blood transfusions in trauma patients.
- Understanding these factors is crucial for improving patient outcomes and resource allocation.
Purpose of the Study:
- To identify patient, transfusion, and laboratory variables associated with survival in trauma patients receiving massive transfusions.
- To determine the costs associated with massive blood transfusions.
Main Methods:
- A retrospective review of 13,005 trauma patient records.
- Analysis of 46 patients who received >=50 units of blood products in the first 24 hours.
- Logistic regression used to predict survival based on patient, laboratory, and transfusion data.
Main Results:
- Overall survival was 63%.
- Arterial base deficit was the only significant independent predictor of survival.
- No significant difference in survival based on age, sex, trauma type, or Day 1 blood component volume.
- Day 2 transfusion volume did not predict survival.
- Average blood transfusion cost exceeded $49,000 per survivor.
Conclusions:
- Transfusion volume alone is insufficient to determine medical futility in trauma patients.
- Further research is needed to identify reliable early indicators of survival.