Death in the operating room: An analysis of a multi-center experience

Hoyt, D; Bulger, Eileen M.; Knudson, M. Margaret; Morris, Joan; Ierardi, R; Sugerman, Harvey J.

doi:10.1016/s1075-4210(05)80032-x

Cited by 82 publications

(107 citation statements)

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“…In contrast, other studies in traumatically injured patients have found an independent association of red blood cell transfusion on mortality, 10,[17][18][19][20]26 with most hemorrhage-related deaths occurring within 24 hr of trauma. 4 This association has been described in patients with primarily blunt trauma 10,19 and in mixed populations with *20% penetrating trauma. 17,18,20 These studies have also demonstrated patient age and severity of injury and illness to predict hospital mortality, raising the possibility 21 HR \ 1 implies a decreased relative hazard of live ICU discharge, that is, a longer ICU stay among survivors as the value of the predictor variable increases.…”

Section: Discussionmentioning

confidence: 94%

“…2 Resuscitation of severe trauma often mandates blood component transfusion, with massive transfusion defined as the administration of at least 10 red blood cell units within the first 24 hr. 3 Among traumatically injured patients, those with massive hemorrhage account for 80% of early mortality 4 and 40% of in-hospital mortality. 5 Transfusion of red blood cells in trauma patients has also been associated with acute lung injury, 6,7 infection, [8][9][10] and multiple organ failure.…”

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confidence: 99%

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Early massive transfusion in trauma patients: Canadian single-centre retrospective cohort study

Mahambrey

Fowler

Pinto

et al. 2009

Can J Anesth/J Can Anesth

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Purpose To determine associations between red blood cell (RBC) transfusion and early and late clinical outcomes in massively transfused adult trauma patients. Methods A retrospective cohort study (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001) including 260 patients receiving C10 RBC units B24 hr after admission to a university-affiliated trauma centre. We extracted demographic and clinical data and used multivariable regression to determine independent effects of RBC transfusion on clinical outcomes. ]).Conclusions Hospital mortality is high among massively transfused trauma patients. Among early survivors, 48-hr RBC transfusion volume is associated with increased organ dysfunction, but not hospital mortality. Also, it is not associated with 48-hr mortality. Future research should continue to explore methods to improve hemostasis and minimize the need for RBC transfusion. RésuméObjectif De´terminer les associations qui existent entre la transfusion d'e´rythrocytes et les devenirs cliniques R. A. Fowler and N. K. J. Adhikari contributed equally to this study.

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Section: Discussionmentioning

confidence: 94%

mentioning

confidence: 99%

Early massive transfusion in trauma patients: Canadian single-centre retrospective cohort study

Mahambrey

Fowler

Pinto

et al. 2009

Can J Anesth/J Can Anesth

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“…Uncontrolled hemorrhage is the second leading cause of death in civilian trauma [1] and the leading cause of preventable death in military trauma [1][2][3][4][5][6][7][8][9]. Historically, 20% of combat casualties were killed in action.…”

Section: Introductionmentioning

confidence: 99%

The Effects of BleedArrest, Celox, and TraumaDex on Hemorrhage Control in a Porcine Model

Gegel

Burgert

Cooley

et al. 2010

Journal of Surgical Research

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Background. Hemorrhage is the second leading cause of death in civilian trauma and the leading cause of preventable death in military trauma. The purpose of this study was to examine the effectiveness of three hemostatic agents: BleedArrest, TraumaDex, and Celox.Materials and Methods. This was a prospective, experimental study using male Yorkshire swine. The pigs (n [ 5 per group) were randomly assigned to one of the following: BleedArrest, TraumaDex, Celox, or control. To simulate a trauma injury, the investigators generated a complex groin injury with transection of the femoral artery and vein in all pigs. After 1 min of uncontrolled hemorrhage, one of the hemostatic agents was poured into the wound, followed by standard wound packing. The control group underwent the same procedures with the exception of the hemostatic agents. In all groups, 5 min of direct manual pressure was applied to the wound followed by a standard pressure dressing. After 30 min, dressings were removed, and the amount of bleeding was determined.Results. There were significant differences between the BleedArrest (mean [ 21.2, SD ± 36.6 mL) TraumaDex (mean [ 68, SD ± 103.5 mL) and Celox (mean [ 18.l6, SD ± 41.6 mL) groups compared with Control group (mean [ 230, SD ± 154 mL) (P < 0.05). However, there were no statistically significant difference between BleedArrest, TraumaDex, and Celox groups (P [ 0.478).Conclusions. BleedArrest, Celox, and TraumaDex were statistically and clinically superior at controlling hemorrhage compared with the standard pressure dressing in the control group. Published by Elsevier Inc.

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“…However, due to the coagulation disorders, hypothermia, acidosis and additional complications associated with blood transfusion, the clinical mortality rate remains high. MT in trauma patients affects a small percentage of civilian and military trauma patients, a great number of whom is expected to succumb to the disease early in their course from hemorrhage and to consume a great deal of trauma center resources (13,(17)(18)(19)(20)(21)(22)(23)(24). In their study, Riskin et al (25) suggested that implementation of a MT protocol and fixed blood component ratio are associated with reduced mortality.…”

Section: Discussionmentioning

confidence: 99%

Fixed rate of blood component improves the survival rate of patients in massive transfusion

Wang

Zhan

et al. 2012

Biomedical Reports

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Abstract. The aim of this study was to examine the manner in which varying proportions of serum and red blood cells (RBC) in massive blood transfusion affect the survival rates of patients with severe blood loss. Massive transfusion (MT) was determined as receiving ≥10 units of red blood cells in 24 h. The electronic medical records and blood transfusion information for the period January, 2002 to December, 2011 of patients with MT were examined. Moreover, we calculated the ratio of blood components and examined their correlation with survival. In total, 1,658 patients underwent MT during the period 2002-2011, with an overall of 28,030 units RBC, accounting for 2.8% of the total blood transfusion. In conclusion, fixing blood-component ratios has the potential to help improve survival rate in MT.

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Death in the operating room: An analysis of a multi-center experience

Cited by 82 publications

References 0 publications

Early massive transfusion in trauma patients: Canadian single-centre retrospective cohort study

Early massive transfusion in trauma patients: Canadian single-centre retrospective cohort study

The Effects of BleedArrest, Celox, and TraumaDex on Hemorrhage Control in a Porcine Model

Fixed rate of blood component improves the survival rate of patients in massive transfusion

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