Academic Department of Military Emergency Medicine, RCDM, Institute of Research and Development, Birmingham, UK.
Emerg Med J. 2013 Apr;30(4):316-9. doi: 10.1136/emermed-2012-201334. Epub 2012 May 19.
Recombinant activated factor VII (rFVIIa) has been used in the management of traumatic haemorrhage for a decade. Anecdotally, its use is decreasing. The aim of this study was to define the use of rFVIIa in UK deployed military hospitals over the last 5 years.
A retrospective database review was performed, using the Joint Theatre Trauma Registry, for the period January 2006 to June 2011. Data collected included use of rFVIIa, injury severity score (ISS), survival and injury pattern. The temporal trend of rFVIIa use, taking into account the number of severely injured patients presenting during each time period, was then analysed.
During the period January 2006 to June 2011, 156 injured patients received rFVIIa. 146 of these (94%) had an ISS >15; there were 45 fatalities. The median ISS among the group receiving rFVIIa was 30, and 20 patients had an ISS in the range 60-75. There was a significant reduction in the use of rFVIIa in the second half of 2010 and the first half of 2011, compared with the previous 12-month period.
The use of rFVIIa in UK deployed military hospitals has declined since 2010, which is likely due to a combination of factors, including a change in resuscitation practice in these units, and a change in emphasis of manufacturer's guidance.
重组活化因子 VII（rFVIIa）已在创伤性出血的治疗中使用了十年。据推测，其使用量正在减少。本研究的目的是确定 rFVIIa 在过去 5 年中在英国部署的军事医院中的使用情况。
使用联合战区创伤登记处，对 2006 年 1 月至 2011 年 6 月期间的数据进行回顾性数据库审查。收集的数据包括 rFVIIa 的使用、损伤严重程度评分（ISS）、存活率和损伤模式。然后分析了 rFVIIa 使用的时间趋势，同时考虑了每个时间段内严重受伤患者的数量。
在 2006 年 1 月至 2011 年 6 月期间，有 156 名受伤患者接受了 rFVIIa 治疗。其中 146 名（94%）ISS>15；有 45 人死亡。接受 rFVIIa 治疗的患者的 ISS 中位数为 30，20 名患者的 ISS 在 60-75 之间。与前 12 个月相比，2010 年下半年和 2011 年上半年 rFVIIa 的使用量显著减少。
自 2010 年以来，英国部署的军事医院中 rFVIIa 的使用量有所下降，这可能是由于这些单位复苏实践的改变以及制造商指南重点的改变等多种因素共同作用的结果。
