@article{ref1,
title="Long-Term Outcomes of Patients Receiving Massive Transfusion After Trauma",
journal="Shock",
year="2014",
author="Mitra, Biswadev and Gabbe, Belinda J. and Kaukonen, Kirsi-Maija and Olaussen, Alexander and Cooper, David J. and Cameron, Peter A.",
volume="42",
number="4",
pages="307-312",
abstract="INTRODUCTION: Resuscitation of patients presenting with haemorrhagic shock after major trauma has evolved to incorporate multiple strategies to maintain tissue perfusion and oxygenation while managing coagulation disorders. We aimed to study changes over time in long-term outcomes in patients with major trauma. <br><br>METHODS: A retrospective observational study in a single major trauma centre in Australia was conducted. We included all patients with major trauma and massive blood transfusion within the first 24 hours over a 6-year period (from 2006 to 2011). The main outcome measures were Glasgow Outcome Score - extended (GOSE), and work capacity at 6 and 12 months. <br><br>RESULTS: There were 5915 patients with major trauma of which 365 (6.2%; 95% CI: 5.6-6.8) received a massive transfusion. The proportion of major trauma patients receiving massive transfusion decreased over time from 8.2 to 4.4% (p<0.01). There were statistically significant trends towards lower volumes of red cell transfusion and higher ratios of fresh frozen plasma to red cells (p<0.01). Among massively transfused patients, there was no significant change in measured outcomes over the study period with a persistent 23% mortality in hospital, 52% unfavourable GOSE at 6-months and 44% unfavourable GOSE at 12-months. Massive transfusion was independently associated with unfavourable outcomes at 6 months following injury (adjusted OR 1.56; 95% CI: 1.05-2.31), but not at 12months (adjusted OR 0.85; 95% CI: 0.72-1.01). <br><br>CONCLUSIONS: A significant reduction in massive transfusion rates was observed. Unfavourable long-term outcomes among patients receiving massive transfusion after trauma were frequent with a substantial proportion of survivors experiencing poor functional status one year after injury.<p /><p>Language: en</p>",
language="en",
issn="1073-2322",
doi="10.1097/SHK.0000000000000219",
url="http://dx.doi.org/10.1097/SHK.0000000000000219"
}