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Massive transfusion: outcome in blunt trauma patients
J H Wudel1, J A Morris, K Yates
1Division of Trauma, Vanderbilt University School of Medicine, Nashville, TN 37212.
The Journal of Trauma
|January 11, 1991
Summary
Massive transfusion (MT) in blunt trauma patients shows a 50% survival rate. Survivors experience excellent long-term outcomes, with most returning to work, despite predictors like shock and head injury.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Critical Care
Background:
- Massive transfusion (MT) protocols are critical for managing severe trauma.
- Understanding outcomes for blunt trauma patients receiving MT is essential for patient care.
Purpose of the Study:
- To evaluate the survival rates and long-term outcomes of blunt trauma patients requiring massive transfusion.
- To identify predictors of mortality in this patient cohort.
Main Methods:
- Retrospective analysis of 6,142 trauma admissions over 54 months.
- Focused on 92 blunt trauma patients receiving ≥20 units of packed red blood cells.
- Followed 43 survivors for a mean of 2.5 years post-discharge.
Main Results:
- 52% of patients requiring MT were long-term survivors.
- Exsanguination was the primary cause of early death (within 24 hours).
- Long-term survivors (mean follow-up 2.5 years) had excellent functional recovery, with 74% returning to work.
Conclusions:
- Blunt trauma patients receiving MT have a 50% survival rate, similar to penetrating trauma.
- Shock, closed head injury, and age are key mortality predictors but do not eliminate survival possibility.
- Long-term prognosis for blunt trauma survivors receiving MT is favorable, with rare post-discharge mortality and high rates of return to work.