High Transfusion Ratios Are Not Associated With Increased Complication Rates in Patients With Severe Extremity Injuries

Abstract

Background: High transfusion ratios of plasma to packed red blood cells (greater than 1:2) have been associated with increased survival and increased complications in patients receiving massive transfusion (MT). We hypothesized that high ratio transfusion would be associated with no survival benefit and increased complications in combat victims with compressible hemorrhage. Methods: A retrospective analysis of soldiers injured in the current conflict during 5 years (n = 2,105) who received blood was performed on those with isolated extremity (abbreviated injury scale extremity score 3 and abbreviated injury scale score 0 -2 in all other regions) injury comparing those who received a MT with those who did not. Transfusion ratios in the first 24 hours were correlated with outcomes. Results: Injury severity score (14.6 vs. 12.1; p less than 0.05), international normalized ratio (1.65 vs. 1.28; p less than 0.05), and base deficit (8.0 vs. 3.7; p less than 0.05) were higher in the MT group. High transfusion ratios were associated with a trend toward decreased mortality (17.2% vs. 6.9%; p = 0.07) in MT patients and no increased complications (20.7% vs. 26.4%; p greater than 0.05). In those receiving a non-MT, high ratios were associated with similar mortality (4.8% vs. 3.9%; p greater than 0.05) and complications (12.4% vs. 9.2%; p greater than 0.05). Conclusions: Extremity injured patients receiving MT may benefit from high transfusion ratios and do not experience increased complications. No change in mortality or complications was observed in non-MT patients across transfusions ratios.

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Document Details

Document Type
Technical Report
Publication Date
Jul 01, 2010
Accession Number
ADA629438

Entities

People

  • Charles E Wade
  • Chitra N. Sambasivan
  • John A. Jones
  • John B Holcomb
  • Lorne H Blackbourne
  • Martin A. Schreiber
  • Philbert Y. Van

Organizations

  • United States Army Institute of Surgical Research

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Air Force
  • Blood
  • Blood Cells
  • Blood Transfusions
  • Body Regions
  • Brain Injuries
  • Cardiovascular Physiological Phenomena
  • Combat Casualty Care
  • Combat Injuries
  • Explosive Devices
  • Health Services
  • Heart Rate
  • Hemorrhage
  • Medical Personnel
  • Military Personnel
  • Patient Care
  • United States

Fields of Study

  • Medicine

Readers

  • Exercise and Sports Science.
  • Immunology
  • Oncology