Department of Anesthesia and Reanimation, Health Sciences University, Gülhane Training and Research Hospital, Ankara-Turkey.
Department of General Surgery, Health Sciences University, Gülhane Training and Research Hospital, Ankara-Turkey.
Ulus Travma Acil Cerrahi Derg. 2020 Nov;26(6):937-942. doi: 10.14744/tjtes.2020.94789.
Blood loss is the most significant cause of mortality in trauma cases. In injured patients, rapid evaluation and appropriate transfusion is lifesaving. The present study aims to analyze the blood/blood products requirement based on available data and find any associations between the transfusion requirements and injury severity scores (ISS) and anatomical locations of injuries of transfused patients.
Between 30 July 2014 and 30 July 2016, casualties admitted to the urban terrain hospital (UTH) and transfused at least one unit of red blood cell (RBC) were included. UTH Transfusion Record Notebook data included patients' age, mechanism and anatomical location(s) of the injury, admission hemoglobin (g/dL) level, injury severity score (ISS), transfused units of erythrocyte suspension (ES), warm fresh whole blood (WFWB), fresh frozen plasma (FFP), and massive transfusion (MT) rate.
In this study, all patients were male; the mean age was 28.7±7.8 years. Overall, 59 of 579 (10%) patients were transfused 458 units of RBC (ES+WFWB). Torso (thorax ± abdomen) injury was present in 61% of the casualties who underwent transfusion, and 93% of these patients underwent massive transfusion. In 71% of patients, the ISS was >15, and there was statistically significant high blood/blood products use and MT rate in these patients, respectively (p=0.021, p=0.006).
Anatomical location of injuries and ISS are valuable in the rapid determining of MT and survival rates of casualties. Especially in torso injuries, bleeding control is difficult and transfusion requirement and mortality rates are high. This study presents the trauma of urban terrain conflict-related transfusion data from a UTH.
失血性休克是创伤患者死亡的主要原因。对于创伤患者，快速评估和及时输血至关重要。本研究旨在分析根据现有数据评估输血需求，并寻找输血需求与损伤严重程度评分（ISS）和受伤部位之间的相关性。
2014 年 7 月 30 日至 2016 年 7 月 30 日期间，我们将在城市地形医院（UTH）收治并至少输注一个单位红细胞（RBC）的伤员纳入本研究。UTH 输血记录笔记本数据包括患者的年龄、受伤机制和解剖部位、入院时血红蛋白（g/dL）水平、损伤严重程度评分（ISS）、输注的红细胞悬液（ES）、新鲜冰冻血浆（FFP）和全血（WFWB）单位数以及大量输血（MT）率。
本研究中所有患者均为男性，平均年龄为 28.7±7.8 岁。共有 579 例患者中 59 例（10%）接受了 458 个单位 RBC（ES+WFWB）的输血。61%的输血患者存在胸部（胸部+腹部）损伤，93%的患者进行了大量输血。71%的患者 ISS>15，这些患者的血液/血制品使用量和 MT 率显著较高（p=0.021，p=0.006）。
损伤的解剖部位和 ISS 可用于快速判断 MT 和伤员存活率。特别是在胸部损伤中，出血控制困难，输血需求和死亡率较高。本研究介绍了 UTH 救治的城市地形冲突相关创伤输血数据。
