Prevalence And Associated Factors Of Massive Transfusion In Adult Major Trauma Patients At Emergency Department Hospital Kuala Lumpur
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Date
2016
Authors
Abdul Wahab, Rahimah
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Background. Our current guideline in managing major trauma in need of massive
transfusion was based on both laboratory and clinical judgement. Some laboratory
investigation is not immediate available that is not in keeping with rapid dynamic of
trauma coagulopathy. Clinician prompt action on patient`s clinical presentation is
essential. Massive transfusion need a lot of blood products thus it required effective
communication between clinician and blood bank. Early recognition of massive
transfusion likelihood in major trauma aid in prompt damage control resuscitation in
major trauma patient.
Objective. To determine the prevalence of major trauma patient among adult and to
determine the associated factors with massive transfusion in subjects enrolled.
Methods. Retrospective study on adult major trauma patients without unfavorable
premorbid condition presented to Emergency Department of Hospital Kuala Lumpur
between June 2015 until May 2016. Associated factors are predefined with seven
variables that are heart rate ≥120/min, systolic blood pressure <90 mmHg, Glasgow
coma scale ≤8, displaced pelvic fracture, FAST scan positive for fluid, base deficit >6
mmol/L, hemoglobin ≤11 g/dL and penetrating injury.
Results. There were 134 patients been recruited, with 3 subjects in massive transfusion
group. (2.27%). Multivariate analysis showed only factor of haemoglobin ≤11 g/dL
(OR 32.443, p-value 0.029, 95% CI 1.423, 739.568) found to be significantly
associated with adult major trauma patients. Other factors do not statistically statistic
due to small sample size.
Conclusions. Prevalence of massive transfusion in adult major trauma patients in
EDHKL was low (2.2%), however only haemoglobin <11 g/dL found to be significantly
associated with massive transfusion in this study.
Description
Keywords
Managing major trauma , in need of massive transfusion