Blood Transfusion, Mortality, Transfusion, Trauma Coagulopathy
Conditions
Brief summary
This retrospective cohort study evaluated transfusion practices and outcomes in 137 severely injured trauma patients requiring massive transfusion at a Level I trauma center (2020-2025). This study analyzed balanced transfusion ratios, whole blood (WB) use, thromboelastography (TEG), and adjunctive hemostatic therapies to determine their impact on 30-day mortality and other clinical outcomes.
Interventions
None listed
Sponsors
Mariah Arif
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adult trauma patients (≥18 years) presenting directly to the trauma center were eligible for inclusion if they met at least one of the following criteria: 1. Injury Severity Score (ISS) ≥16, or 2. requirement for massive transfusion, defined as \>10 units of packed red blood cells (PRBC) within the first 24 hours.
Exclusion criteria
* Death on arrival, * Transfer from external institutions after initial resuscitation * Incomplete transfusion or outcome data * Significant pre-existing comorbidities (including advanced heart failure, end-stage renal disease, cirrhosis with portal hypertension, chronic oxygen dependence, or non-reversible anticoagulation therapy). * Patients with isolated minor injuries not requiring trauma team activation were also excluded.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 30-day all cause mortality | 30 days post-transfusion |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| in-hospital mortality | From date of hospital admission until date of death, assessed up to 60 months | — |
| ICU length of stay | from date of ICU admission until date of ICU discharge, assessed up to 60 months | — |
| Hospital length of stay | from admission till discharge or death | — |
| Ventilator-free days | Within 28 days post-ventilator use | — |
| Acute kidney injury | Increase in serum creatinine by ≥0.3 mg/dL within 48 hours, or Increase in serum creatinine to ≥1.5 times baseline within 7 days, or Urine output <0.5 mL/kg/hour for 6 hours. | — |
| thromboembolic events | from date of admission up till date of discharge, assessed up to 60 months | deep vein thrombosis, pulmonary embolism, stroke |
| Number of participants with multiorgan failure | From date of hospital admission until date of documented organ failure, assessed unto 60 months | Multiorgan failure (MOF) was defined as dysfunction or failure of two or more organ systems as assessed by the Sequential Organ Failure Assessment (SOFA) score. |
| Transfusion related complications | Within 6 hours of transfusion | Transfusion related acute lung injury, Transfusion associated circulatory overload |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORAyten Saracoglu
University of Florida
Outcome results
None listed