Age-Related Mortality in Trauma Patients Requiring Massive Transfusion.

Area of Science:

• Trauma Surgery
• Geriatric Medicine
• Critical Care Medicine

Background:

• Massive transfusion (MT) protocols are vital for trauma survival.
• Elderly trauma patients requiring MT are a high-risk group with limited outcome data.
• Understanding age-related differences in MT outcomes is crucial for resource allocation.

Purpose of the Study:

• To compare mortality rates between elderly (≥65 years) and non-elderly (<65 years) trauma patients requiring MT.
• To characterize age-related differences in outcomes following massive transfusion in trauma.

Main Methods:

• Retrospective analysis of trauma patients requiring MT (≥10 units of whole blood and/or packed red blood cells within 24 hours).
• Comparison of 30-day mortality, ICU length of stay, hospital length of stay, and ventilator days between elderly and non-elderly groups.
• Adjusted Cox regression analysis to determine the association between age and mortality.

Main Results:

• Elderly patients (8% of cohort) had significantly higher 30-day mortality (73% vs 49%, P < 0.01) compared to non-elderly patients.
• Elderly patients experienced a shorter median time to death (14 vs 34 days, P < 0.01).
• Adjusted Cox regression revealed a significantly higher adjusted mortality risk in the elderly (HR 1.25, P = 0.04).

Conclusions:

• Elderly trauma patients undergoing massive transfusion face significantly higher and earlier mortality.
• These findings underscore the necessity for enhanced risk stratification and individualized resuscitation protocols for elderly trauma patients.
• Further research is warranted to develop targeted interventions for this high-risk demographic.