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Intraoperative platelet and plasma improves survival in patients operated for a rAAA: a follow-up evaluation
P I Johansson1, F Swiatek, L Jørgensen
1Department of Clinical Immunology, Faculty of Health Science, Rigshospitalet, University of Copenhagen, Denmark. per.johansson@rh.regionh.dk
Objectives:
Continued haemorrhage remains a significant contributor to mortality in massively transfused patients. We found that early administration of platelets and plasma reduced mortality from 54% to 36% in rAAA patients. The aim of the present evaluation was to evaluate whether reduced mortality in rAAA patients related to a pro-active transfusion therapy is maintained.
Design:
Single-centre observational study.
Methods:
Mortality of patients operated for rAAA 2006-07 was compared to that of patients operated 2004-05 (intervention group; n=50) and 2002-04 (control group, n=82).
Results:
64 consecutive patients with rAAA received, similar to the intervention group, more platelets (5 and 4 vs. 0 units, P<0.05) and plasma (12 and 11 vs. 7 units, P<0.05) intraoperatively and had a higher platelet count (158 and 155 vs. 69 x 10(9)/L, P<0.0001) upon arrival at the intensive care unit and the 30-day mortality remained reduced (24% and 36% vs. 56%, P<0.01 and P=0.02, respectively) as compared to the control patients.
Conclusions:
Early administration of platelets and plasma, together with red blood cells maintained reduced mortality in patients operated for rAAAin a 18 month period.