J Trauma
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Multicenter Study
Gender-based differences in mortality in response to high product ratio massive transfusion.
Recent data suggest that patients undergoing massive transfusion have lower mortality rates when ratios of plasma and platelets to red blood cells (RBCs) of ≥ 1:2 are used. This has not been examined independently in women and men. A gender dichotomy in outcome after severe injury is known to exist. This study examined gender-related differences in mortality after high product ratio massive transfusion. ⋯ Use of high plasma:RBC or platelet:RBC ratios in massive transfusion may benefit men more than women. This may be due to gender-related differences in coagulability. Further study is needed to determine whether separate protocols for women and men should be established.
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Multicenter Study
Effect of high product ratio massive transfusion on mortality in blunt and penetrating trauma patients.
Recent data suggest that massively transfused patients have lower mortality rates when high ratios (>1:2) of plasma or platelets to red blood cells (RBCs) are used. Blunt and penetrating trauma patients have different injury patterns and may respond differently to resuscitation. This study was performed to determine whether mortality after high product ratio massive transfusion is different in blunt and penetrating trauma patients. ⋯ Use of high plasma:RBC ratios during massive transfusion may benefit penetrating trauma patients to a greater degree than blunt trauma patients. High platelet:RBC ratios did not benefit either group.
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Randomized Controlled Trial Multicenter Study Comparative Study
Recombinant activated factor VII safety in trauma patients: results from the CONTROL trial.
Safety data on recombinant activated factor VII (rFVIIa, NovoSeven; Novo Nordisk A/S, Bagsværd, Denmark) in actively hemorrhaging trauma patients are limited. We present detailed safety data from a large multicenter, randomized, placebo-controlled phase III study (the CONTROL trial). ⋯ This represents the largest placebo-controlled dataset of rFVIIa use in trauma patients to date. In this prospective study of critically bleeding trauma patients, rFVIIa use was associated with an imbalance of investigator-reported Acute myocardial infarction/non-ST segment elevation myocardial infarction (AMI/NSTEMI), but was not associated with an increased risk for other AEs, including TE complications.
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Multicenter Study Comparative Study
Outcomes of trauma victims with cardiac arrest who survive to intensive care unit admission.
The prognosis for patients with return of spontaneous circulation after trauma-related cardiac arrest (TRCA) is unclear. Our purpose was to (1) determine outcomes for patients with TRCA resuscitated and admitted to the intensive care unit (ICU), (2) identify ICU-based predictors of in-hospital death in this population, and (3) compare outcomes of patients resuscitated from TRCA and atraumatic cardiac arrest (ATCA). ⋯ Despite lower survival than ATCAs, a significant percentage of TRCAs surviving to ICU admission were discharged alive. This suggests aggressive support of this population is not necessarily futile. Investigation into whether optimization of postresuscitation factors would improve outcome for these patients may be warranted.
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Multicenter Study Comparative Study
Impact of the version of the abbreviated injury scale on injury severity characterization and quality assessment of trauma care.
The Abbreviated Injury Scale (AIS) was updated in 2008 (AIS 2008). We aimed to investigate the impact of AIS 2008 on the characterization of injury severity and quality assessment of trauma care. ⋯ The use of different AIS versions influenced the selection of major trauma patients and affected the quality assessment of the trauma care. Researchers should be aware of these findings when selecting the version of the AIS.