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Related Concept Videos

Blood Transfusion and Agglutination02:45

Blood Transfusion and Agglutination

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Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
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Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
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Cryoprecipitate use during massive transfusion: A propensity score analysis.

Andrew M Fleming1, Kinjal S Shah2, Saskya E Byerly3

  • 1Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave, 2nd Floor, Memphis, TN, United States.

Injury
|March 4, 2022
PubMed
Summary

Early cryoprecipitate administration in massive transfusion for trauma did not improve survival. Propensity score analysis showed no survival benefit, suggesting further prospective studies are needed for exsanguinating hemorrhage.

Keywords:
CoagulopathyCryoprecipitateFibrinogenHemorrhageTransfusionTrauma

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Area of Science:

  • Trauma resuscitation
  • Hemorrhagic shock management
  • Blood product transfusion

Background:

  • Cryoprecipitate is a common adjunct in traumatic hemorrhage management.
  • Previous civilian studies lack clear survival advantage data for cryoprecipitate.
  • Inconsistent implementation and selection bias complicate analysis of cryoprecipitate use.

Purpose of the Study:

  • To evaluate the impact of early cryoprecipitate administration on inpatient mortality.
  • To assess survival outcomes in massive transfusion for exsanguinating trauma.
  • To minimize selection bias using propensity score analysis.

Main Methods:

  • Retrospective query of an urban level 1 trauma center registry.
  • Inclusion criteria: adult patients receiving ≥6 units of packed red blood cells within 4 hours.
  • Analysis methods included univariate analysis, logistic regression, and propensity score matching.

Main Results:

  • 562 patients were identified; cryoprecipitate recipients had lower RTS, GCS, and higher lactate.
  • Univariate analysis showed higher mortality in cryoprecipitate recipients (40.2% vs 23.7%).
  • Logistic regression and propensity score matching found no significant association between early cryoprecipitate and inpatient mortality.

Conclusions:

  • Patients receiving early cryoprecipitate were more severely injured with higher mortality.
  • Multivariable and propensity score analyses did not demonstrate a survival benefit.
  • Prospective investigation is warranted to definitively assess cryoprecipitate utility in exsanguinating hemorrhage.