Journal article
Massive transfusion protocol and subsequent development of venous thromboembolism: Statewide analysis
The American Surgeon, Vol.87(1), pp.15-20
2020
Abstract
Background
Massive transfusion protocols (MTP) are a routine component of any major trauma center’s armamentarium in the management of exsanguinating hemorrhages. Little is known about the potential complications of those that survive a MTP. We sought to determine the incidence of venous thromboembolism (VTE) following MTP. We hypothesized that MTP would be associated with a higher risk of VTE when compared with a risk-adjusted control population without MTP.
Methods
The Pennsylvania Trauma Outcome Study database was retrospectively queried from 2015 to 2018 for trauma patients who developed VTE and survived until discharge at accredited trauma centers in Pennsylvania. Patient demographics, injury severity, and clinical outcomes were compared to assess differences in VTE development between MTP and non-MTP patients. A multivariate logistic regression model assessed the adjusted impact of MTP on VTE development.
Results
176 010 patients survived until discharge, meeting inclusion criteria. Of those, 1667 developed a VTE (pulmonary embolism [PE]: 662 [0.4%]; deep vein thrombosis [DVT]: 1142 [0.6%]; PE and DVT: 137 [0.1%]). 1268 patients (0.7%) received MTP and, of this subset of patients, 171 (13.5%) developed a VTE during admission. In adjusted analysis, patients who had a MTP and survived until discharge had a higher odds of developing a VTE (adjusted odds ratio: 2.62; 95% CI: 2.13-3.24; P < .001).
Discussion
MTP is a harbinger for higher risk of VTE in those patients who survive. This may, in part, be related to the overcorrection of coagulation deficits encountered in the hemorrhagic event. A high index of suspicion for the development of VTE as well as aggressive VTE prophylaxis is warranted in those patients who survive MTP.
Details
- Title
- Massive transfusion protocol and subsequent development of venous thromboembolism: Statewide analysis
- Authors/Creators
- E.H. Bradburn (Author/Creator)K.M. Ho (Author/Creator)M.E. Morgan (Author/Creator)L. D’Andrea (Author/Creator)T.M. Vernon (Author/Creator)F.B. Rogers (Author/Creator)
- Publication Details
- The American Surgeon, Vol.87(1), pp.15-20
- Publisher
- SAGE Publications
- Identifiers
- 991005541446507891
- Copyright
- © 2021 by Southeastern Surgical Congress
- Murdoch Affiliation
- School of Veterinary Medicine
- Language
- English
- Resource Type
- Journal article
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Source: InCites
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.75 Blood Clotting
- 1.75.324 Transfusion
- Web Of Science research areas
- Surgery
- ESI research areas
- Clinical Medicine