| Emergency department blood transfusion predicts early massive transfusion and early blood component requirement. | |
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MedLine Citation:
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PMID: 20456707 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this study was to evaluate the ability of uncrossmatched transfusions in the emergency department (ED) to predict early (< 6 hr) massive transfusion (MT) of red blood cells (RBCs) and blood components. STUDY DESIGN AND METHODS: All patients admitted to a Level 1 trauma center between July 2005 and June 2007 who received any transfusions and were transported directly from the scene of injury were included. Early MT was defined as the need for 10 U or more or RBCs in the first 6 hours. Early MT plasma was defined as 6 U or more of plasma in the first 6 hours. Early MT platelets (PLTs) were defined as two or more apheresis transfusions in the first 6 hours. Univariate and multivariate analyses were performed. RESULTS: A total of 485 patients (34%) received ED transfusions (ED RBC+) and 956 (66%) did not receive ED transfusions (ED RBC-). ED RBC+ patients were younger, were more likely to be male, and arrived with more severe injuries. Multivariate regression identified ED transfusion of uncrossmatched RBC as an independent predictor of requiring early MT of RBCs (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.36-7.59; p = 0.001), plasma (OR, 2.7; 95% CI, 1.66-4.39; p < 0.001), and PLTs (OR, 1.9; 95% CI, 1.08-3.41; p = 0.025). CONCLUSION: Patients receiving uncrossmatched RBCs in the ED are more than three times more likely to receive early MT of RBCs. Additionally, patients transfused with ED RBCs are more likely to receive 6 units or more of plasma and two or more apheresis PLT transfusions. Given these findings, ED transfusion of uncrossmatched RBCs should be considered a potential trigger for activation of an institution's MT protocol. |
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Authors:
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Timothy C Nunez; William D Dutton; Addison K May; John B Holcomb; Pampee P Young; Bryan A Cotton |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Transfusion Volume: 50 ISSN: 1537-2995 ISO Abbreviation: Transfusion Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-11-05 Completed Date: 2010-12-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417360 Medline TA: Transfusion Country: United States |
Other Details:
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Languages: eng Pagination: 1914-20 Citation Subset: IM |
Copyright Information:
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© 2010 American Association of Blood Banks. |
Affiliation:
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Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Component Transfusion / statistics & numerical data* Blood Transfusion / statistics & numerical data* Erythrocyte Transfusion / statistics & numerical data Female Humans Injury Severity Score Male Middle Aged Multivariate Analysis Retrospective Studies Trauma Centers / statistics & numerical data |
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