Article Figures & Data
Tables
- Table 1
Demographics of all patients receiving uncrossmatched blood from ED refrigerator
Patients receiving any uncrossmatched red blood cells in the ED (n) 158 Age, median (range) 50 (16–91) Sex 97 male (61.4%)/
61 female (38.6%)Penetrating 26 (16.5%) Massive transfusion protocol activations 89 (56.3%) Etiology Trauma 140 (88.6%) Gastrointestinal bleeds 6 (3.8%) Abdominal aortic aneurysms 5 (3.2%) Gynecology-related 3 (1.9%) Medical anemia 2 (1.3%) General surgery-related 1 (0.6%) Ear, nose and throat-related 1 (0.6%) Injury Severity Score*, median (range) 24 (2–75) Glasgow Coma Scale score*, median (range) 11 (3–15) ED fridge units transfused (n) 292 ED fridge units transfused (n), median (range) 2.0 (1–6) Total units transfused in 24 hours (n) 1172 Total units transfused in 24 hours (n), median (range) 4.0 (1–55) Patients who received >10 units (n) 37 (23.4%) *Trauma patients only.
ED, emergency department.
- Table 2
Transfusion data based on 24-hour survival
Died within 24 hours Survived 24 hours P values n 42 116 Emergency department fridge units received, median (range) 2 (1–6) 1 (1–4) <0.001 Total units received in 24 hours, median (range) 7 (1–32) 4 (1–55) 0.046 Received ≥10 units in 24 hours 15 (35.7%) 22 (19.0%) 0.028 Massive transfusion protocol activated 30 (71.4%) 59 (50.9%) 0.029 Etiology Trauma (vs following) 36 (85.7%) 104 (89.7%) 0.572 Abdominal aortic aneurysms 4 2 Medical anemia 0 2 Gastrointestinal bleeds 2 4 Gynecology-related 0 3 Ear, nose and throat-related 0 1 General surgery-related 1 0 - Table 3
Demographic data by the number of uncrossmatched units received in 24-hour survivors
≤2 units >2 units P values Patients (n) 29 87 Age, mean (SD) 50 (17) 47 (18) 0.365 Female 12 (41.4%) 35 (40.2%) 1.000 Penetrating 2 (6.9%) 17 (19.5%) 0.151 Trauma etiology (%) 24 (82.8%) 80 (92.0%) 0.171 Abdominal aortic aneurysms 0 2 Medical anemia 2 0 Ear, nose and throat-related 1 0 Gastrointestinal bleeds 1 3 Gynecology-related 1 2 Injury Severity Score, median (range) 21.5 (2–34) 26 (4–50) 0.119 Glasgow Coma Scale score, median (range) 14 (3–15) 14 (3–15) 0.118 Abbreviated Injury Scale score, head, median (range) 0 (0–4) 0 (0–5) 0.905 - Table 4
Clinical data in 24-hour survivors
≤2 units >2 units P values n 29 87 Positive FAST 4 (14%) 26 (30%) 0.140 Pelvic fracture 7 (24%) 28 (32%) 0.336 Systolic blood pressure, mean (SD) 116 (33) 102 (31) 0.042 Systolic blood pressure ≤90 6 (21%) 33 (39%) 0.112 Heart rate, mean (SD) 94 (29) 105 (29) 0.093 Heart rate ≥120 6 (21%) 28 (33%) 0.248 pH, mean (SD) 7.3 (0.1) 7.2 (0.1) 0.238 PCO2 (mm Hg), mean (SD) 44 (14) 44 (13) 0.959 PO2 (mm Hg), mean (SD) 86 (69) 148 (118) 0.001 Lactate (mmol/L), mean (SD) 3.4 (2.7) 4.5 (3.3) 0.159 Base deficit (mEq/L), mean (SD) 6.4 (5.8) 9.4 (6.3) 0.032 Admission hematocrit (%), mean (SD) 34 (6) 30 (8) 0.024 Massive transfusion protocol activated 8 (28%) 51 (59%) 0.005 Received fresh frozen plasma 5 (17%) 47 (54%) 0.001 Received platelets 4 (14%) 34 (39%) 0.012 Received cryoprecipitate 1 (3%) 15 (17%) 0.069 Discharged alive 26 (90%) 73 (84%) 0.556 FAST, focused assessment with sonography for trauma; PCO2, partial pressure of carbon dioxide; PO2, partial pressure of oxygen.
- Table 5
Institutional MTP criteria during the study period
Admission clinical criteria Operating room clinical criteria Laboratory criteria SBP ≤70 mm Hg Non-surgical hemorrhage Base deficit >8 Crystalloid >4 L EBL >150 cc/min International Normalized Ratio >1.4 Estimated Blood Loss (EBL) >1000 cc Prothrombin Time >18 s SBP <90 despite 3.5 L crystalloid Partial Thromboplastin Time >60 s Temperature <34°C Admission Hct <30 ISS >25 pH <7.1 Only one of the criteria had to be met for activation of massive transfusion protocol.
ISS, Injury Severity Score; SBP, systolic blood pressure.
