| The association of blood component use ratios with the survival of massively transfused trauma patients with and without severe brain injury. | |
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MedLine Citation:
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PMID: 21814102 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The effect of blood component ratios on the survival of patients with traumatic brain injury (TBI) has not been studied. METHODS: A database of patients transfused in the first 24 hours after admission for injury from 22 Level I trauma centers over an 18-month period was queried to find patients who (1) met different definitions of massive transfusion (5 units red blood cell [RBC] in 6 hours vs. 10 units RBC in 24 hours), (2) received high or low ratios of platelets or plasma to RBC units (<1:2 vs. ≥ 1:2), and (3) had severe TBI (head abbreviated injury score ≥ 3) (TBI+). RESULTS: Of 2,312 total patients, 850 patients were transfused with ≥ 5 RBC units in 6 hours and 807 could be classified into TBI+ (n = 281) or TBI- (n = 526). Six hundred forty-three patients were transfused with ≥ 10 RBC units in 24 hours with 622 classified into TBI+ (n = 220) and TBI- (n = 402). For both high-risk populations, a high ratio of platelets:RBCs (not plasma) was independently associated with improved 30-day survival for patients with TBI+ and a high ratio of plasma:RBCs (not platelets) was independently associated with improved 30-day survival in TBI- patients. CONCLUSIONS: High platelet ratio was associated with improved survival in TBI+ patients while a high plasma ratio was associated with improved survival in TBI- patients. Prospective studies of blood product ratios should include TBI in the analysis for determination of optimal use of ratios on outcome in injured patients. |
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Authors:
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K J Brasel; G Vercruysse; Philip C Spinella; Charles E Wade; Lorne H Blackbourne; Matthew A Borgman; Lee A Zarzabal; Fei Du; Jeremy G Perkins; Marc Maegele; Martin Schreiber; John R Hess; Kenneth M Jastrow; Ernest A Gonzalez; John B Holcomb; Rosemary Kozar; ; K J Brasel; G Vercruysse; J MacLeod; R P Dutton; J C Duchesne; N E McSwain; P Muskat; J Johannigamn; H M Cryer; H M Cryer; J F Pittet; P Knudson; M A De Moya; B Tieu; S Brundage; L M Napolitano; M Brunsvold; K C Sihler; G Beilman; A B Peitzman; M S Zenait; J Sperry; L Alarcon; M A Croce; J P Minei; R M Stewart; S M Cohn; J E Mickalek; E M Bulger; B A Cotton; T C Nunez; R Ivatury; J W Meredith; P Miller; G J Pomper; B Marin |
Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: The Journal of trauma Volume: 71 ISSN: 1529-8809 ISO Abbreviation: J Trauma Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-08-04 Completed Date: 2011-10-24 Revised Date: 2012-03-27 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: S343-52 Citation Subset: AIM; IM |
Affiliation:
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Department of Pediatrics, St Louis Children's Hospital, St Louis, Missouri 63110, USA. spinella_p@wustl.kids.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Component Transfusion* Brain Injuries / blood, mortality*, therapy* Erythrocyte Count Female Humans Male Middle Aged Platelet Count Retrospective Studies Survival Rate Trauma Centers Treatment Outcome Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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