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Epidemiology of acute transfusions in major orthopaedic trauma.
MedLine Citation:
PMID:  23343886     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES:: The orthopaedic trauma related blood product usage is largely unknown. Aim of this study was to describe the epidemiology of early (<24hrs of arrival) blood component use in major orthopaedic trauma. DESIGN:: 12-month prospective observational study. SETTING:: John Hunter Hospital, Level 1 Trauma Centre, New South Wales, Australia. PATIENTS:: 64 consecutive trauma admissions identified, who had an orthopaedic injury and required at least one unit of packed red blood cells (PRBC) <24hours of arrival.Intervention: epidemiological study. MAIN OUTCOME MEASURES:: Demographics, orthopaedic injury type, procedure type, injury severity score (ISS), timing, place of first unit of transfusion, blood component volumes were collected. Activation of the massive transfusion protocol (MTP) was recorded. Primary outcome measures were ICU admission and mortality. RESULTS:: From 965 major trauma admissions 64 had one or more orthopaedic injuries and were transfused <24 hours. Forty-eight per cent (31/64) required MTP activation. Average age was 41±21 years, 73% (47/64) male. Eighty-four percent (54/64) required emergent orthopaedic intervention, 41% (22/54) having multiple procedures. Overall mortality was 13% (8/64). Twenty-five percent (16/64) required ≥10 units of PRBC. Average PRBC use was 7.2±6.6 units, FFP use 4.3±5.2 units. Thirty-nine percent (25/64) had a pelvic ring injury or acetabular fracture. Thirty-seven percent (24/64) had at least one femoral shaft fracture. Twenty patients had a total of 23 tibia fractures. CONCLUSIONS:: Orthopaedic trauma patients consume the majority of the blood products <24hrs amongst blunt trauma patients. This resource intensive group requires frequent urgent surgical interventions and ICU admission.
Authors:
Krisztian Sisak; Michael Manolis; Benjamin M Hardy; Natalie Enninghorst; Zsolt J Balogh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-22
Journal Detail:
Title:  Journal of orthopaedic trauma     Volume:  -     ISSN:  1531-2291     ISO Abbreviation:  J Orthop Trauma     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807705     Medline TA:  J Orthop Trauma     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Department of Traumatology, Division of Surgery, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia 2Hunter Area Pathology Service, John Hunter Hospital, Newcastle, NSW, Australia Correspondence to: Zsolt J. Balogh, MD, PhD, FRACS, Department of Traumatology, Division of Surgery, John Hunter Hospital and University of Newcastle, Newcastle, NSW 2310, Australia, Tel: +61 249214259; fax: +61 249214279; Zsolt.Balogh@hnehealth.nsw.gov.au.
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