Platelet to erythrocyte ratio and mortality in massively transfused trauma patients.

Autor: Rijnhout TWH; Department of Surgery, Alrijne Medical Centre, 2353 GA Leiderdorp, the Netherlands; Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands. Electronic address: t.rijnhout@erasmusmc.nl., Noorman F; Military Blood Bank, Ministry of Defence, 3584 EZ Utrecht, the Netherlands. Electronic address: f.noorman@mindef.nl., Tan ECTH; Department of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands. Electronic address: edward.tan@radboudumc.nl., Viersen VVA; Department of Anaesthesiology, Amsterdam University Medical Centre, Amsterdam, the Netherlands. Electronic address: v.a.viersen@amsterdamumc.nl., van der Burg BLSB; Department of Surgery, Alrijne Medical Centre, 2353 GA Leiderdorp, the Netherlands. Electronic address: blsborgervanderburg@alrijne.nl., van Bohemen M; Department of Haematology, Erasmus MC, University Medical Centre Rotterdam, CE 3015 Rotterdam, the Netherlands. Electronic address: m.vanbohemen@erasmusmc.nl., Waes OJFV; Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, 3000 CA Rotterdam, the Netherlands. Electronic address: o.vanwaes@erasmusmc.nl., Verhofstad MHJ; Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, 3000 CA Rotterdam, the Netherlands. Electronic address: m.verhofstad@erasmusmc.nl., Hoencamp R; Department of Surgery, Alrijne Medical Centre, 2353 GA Leiderdorp, the Netherlands; Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, 3000 CA Rotterdam, the Netherlands; Defence Healthcare Organization, Ministry of Defence, 3584 AB Utrecht, the Netherlands; Department of Surgery, Leiden University Medical Centre, 2333 ZA Leiden, the Netherlands. Electronic address: r.hoencamp@erasmusmc.nl.
Jazyk: angličtina
Zdroj: Injury [Injury] 2024 Nov 12, pp. 112021. Date of Electronic Publication: 2024 Nov 12.
DOI: 10.1016/j.injury.2024.112021
Abstrakt: Background: The optimal transfusion ratio of platelets (PLT), plasma and red blood cells (RBC) in trauma patients with massive haemorrhage is still a subject of discussion. The objective of this study is to assess the effect of platelet transfusion on mortality in trauma patients who received massive transfusion.
Methods: Data were collected from four Dutch level-1 trauma centres. All trauma patients aged ≥ 16 years who received ≥ 6 RBC / 6 h from the time of injury were included. Patients were divided based on PLT:RBC ratio (no platelets, low (<1:5) and high (≥1:5)). Primary outcome measure was 6-hour mortality and secondary outcomes included mortality at other time points and transfusion characteristics.
Results: A total of 292 patients were included. Patients in the high PLT ratio group had lower mortality rates at six and 12 h as compared to the low PLT ratio and no PLT group. In the high PLT group mortality as a result of exsanguination (12 %) was significantly lower as compared to the low PLT group (23 %). High PLT ratio had lower probability for 6-hour mortality multivariable analysis. Higher plasma:RBC ratios were associated with lower mortality at all time points.
Conclusions: Although the optimal patient specific transfusion strategy in patients with traumatic haemorrhage is still not resolved, these results show that higher PLT to RBC ratios are associated with lower early mortality.
Competing Interests: Declaration of competing interest The authors declare that they have no competing interests.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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