Changes in red cell transfusion practice among adult trauma victims.
Annual Meeting of the Trauma Association of Canada. Vancouver, BC, CAN, 1997/09/25.
Recent attention concerning the adverse outcomes of blood transfusion has resulted in decreased blood product usage for nonemergency care.
We hypothesized that there has also been a decrease in blood product use in the management of seriously injured adults.
A retrospective review of institutional database records was conducted at a regional trauma center for adults admitted during 1991,1993, and 1995.
Data was analyzed for trends in amount, type, and timing of blood product use.
A total of 1,738 patients were assessed, with 1,605 meeting inclusion.
The three patient groups were similar, including injury severity (overall mean Injury Severity Score of 23.6), mechanism (88% blunt), and survival (87%). In 1991,54% of the patients were transfused a total of 2,341 units of packed red blood cells (mean 4.67 units/pt treated) versus 42% of patients in 1995 (p<0.0001) who received 2,018 packed red blood cells (mean 3.57 units/patient treated, p=0.05).
A significantly higher proportion of units was transfused in the first 24 hours of care in 1995 (64%) compared with 1991 (21%, p<0.0001).
A reduction in the use of universal donor type-O blood use was also found (1.21 vs. 0.65 units/patient transfused, p<0.0001).
Despite similar admission hemoglobin concentrations (124.1 vs. 125.3, not significant), significant reductions were found in the average 24-hour (109.2 vs. 103.8, p<0.001), lowest (96.5 vs 92.1, p<0.01) and discharge (115.8 vs. 110. (...)
Mots-clés Pascal : Traumatisme, Malade état grave, Transfusion, Sang, Complication, Relation, Diminution, Indication, Instruction, Homme, Médecine catastrophe, Réanimation
Mots-clés Pascal anglais : Trauma, Critically ill, Transfusion, Blood, Complication, Relation, Decrease, Indication, Instruction, Human, Disaster medicine, Resuscitation
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0236590
Code Inist : 002B27D01. Création : 11/09/1998.