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Table 2 Clinical presentation and complications based on high and low transfusion ratios within the first 4 h post-injury

From: Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time

 

HMTP (n = 31)

LMTP(n = 46)

P value

Age (mean ± SD)

29.7 ± 9.5

37.6 ± 16.5

0.03

Blunt injury (%)

87.1

89.1

0.53

Penetrating injury (%)

12.9

10.9

Saline (Prehospital)

1193 ± 666

1197 ± 737

0.97

Transport Time (min.)

64.4 ± 29.8

63.7 ± 34.3

0.93

Prehospital interventions

   

  Intubation

36 %

41 %

0.60

  Thoracostomy

3 %

9 %

0.32

Laboratory findings

   

  Initial Hemoglobin (mean ± SD)

10.6 ± 3

10 ± 2.3

0.37

  Initial INR

1.3 (1–10)

1.3 (1–3)

0.09

  Initial pH

7.2 ± 0.14

7.1 ± 0.2

0.09

  *1ST MTP INR

1.35 (1–2)

1.7 (1–12)

0.09

  1st MTP pH

7.2 ± 0.16

7.1 ± 0.23

0.04

  2nd MTP INR

1.1 (1–3)

1.5 (1–3)

0.03

  2nd MTP pH

7.3 ± 0.1

7.2 ± 0.2

0.04

  3rd MTP INR

1.1 (1–2)

1.2 (1–10)

0.17

  3rd MTP pH

7.2 ± 0.18

7.2 ± 0.2

0.55

  Saline

3456 ± 1591

3929 ± 1258

0.15

  Ringer Lactate

883 ± 431

1550 ± 1099

0.01

  Saline + Ringer lactate

3883 ± 1580

4771 ± 1466

0.01

  Cryoprecipitate

9.5 ± 0.7

8.4 ± 3.5

0.70

  Calcium Gluconate/Chloride

1933 ± 1334

2250 ± 1674

0.54

  Sodium Bicardonate

92.9 ± 73

152.3 ± 96

0.05

  Fibrinogen

2800 ± 1095

3000 ± 1341

0.77

  Factor VII

5.2 ± 2.4

3.8 ± 1.3

0.19

Injuries

   

  Head injury

52

48.6

0.80

  Lung contusion

68

59

0.42

  Rib fracture

47

28

0.10

  Pelvic fracture

52

43

0.47

  Long bone fracture

45

23

0.04

  Spleen

19

33

0.2

  Liver

26

37

0.3

  Cardiac

0

9

0.09

Injury Severity Score

29.4 ± 11.6

32.5 ± 10.7

0.24

Revised Trauma Score

5.2 ± 2.3

5.2 ± 2.02

0.97

Glasgow Coma Score

8.5 ± 5

8 ± 5.1

0.72

Hyperkalemia (%)

17.2

29.3

0.19

Hypomagnesemia (%)

68.2

61

0.42

Hypocalcemia (%)

93

82

0.17

Complications

   

  Ventilator-associated Pneumonia (%)

32.3

14

0.05

  Wound infection (%)

32.3

18.6

0.14

  Bloodstream Infection (%)

6.5

11.6

0.37

  CRBSI (%)

3.2

7

0.44

  Urinary tract infections (%)

3.2

4.7

0.62

  ACS (%)

6.5

2.2

0.35

  1. HMTP high transfusion ratios, LMTP low transfusion ratios, INR, international normalized ratio, ACS abdominal compartment syndrome, CRBSI Catheter related Blood Stream Infection, MTP massive transfusion protocol