J Trauma
-
Benefits of high ratios of fresh frozen plasma (FFP) to packed red blood cells (pRBC) in massively transfused trauma patients have been reported previously. This study aimed to assess the effect of higher FFP:pRBC ratios on outcome in patients receiving less than massive transfusion during acute trauma care. ⋯ Trauma patients receiving less than massive transfusion might also benefit from higher FFP:pRBC ratios, as these were associated with significantly lower mortality rates and decreased blood product utilization during subsequent ICU treatment, whereas morbidity was comparable among groups. Additional prospective trials are necessary.
-
Review Meta Analysis
Outcomes of proximal versus distal splenic artery embolization after trauma: a systematic review and meta-analysis.
The objective of this systematic review and meta-analysis was to assess the outcomes after angioembolization in blunt trauma patients with splenic injuries and to examine specifically the impact of the technique used. Studies evaluating adult trauma patients who sustained blunt splenic injuries managed by angioembolization were systematically evaluated. The following data were required for inclusion: grade of splenic injury, indication for embolization, and site of embolization (proximal [main splenic artery] or distal [selective]). ⋯ However, both techniques have an equivalent rate of infarctions and infections requiring splenectomy. Minor complications occur more often after distal embolization. This is primarily explained by the higher rate of segmental infarctions after distal embolization.
-
Indications for direct transport may be strongly related to risk of future health outcomes, and these indications may not be adequately controlled by considering only in-hospital variables. This study was designed to identify prehospital factors associated with directness of transport. ⋯ Confounding due to unadjusted prehospital factors may be present in studies evaluating the impact of directness of transport on short-term mortality outcomes. Propensity score analysis of treatment indications provides an additional and efficient method to reduce this bias.