Korean J Blood Transfus.  2013 Dec;24(3):275-285.

Prediction of Massive Blood Transfusion at Emergency Department in Non-trauma Patients

• You KY
• Kim JY
• Choi SH
• Yoon YH
• Lim CS
• Park SM

Abstract

BACKGROUND
Many patients received transfusion in emergency department because of blood loss. There are few studies on massive transfusion for non-traumatic patients. This study investigated mortality and risk factor for non-traumatic bleeding patients who received transfusion.
METHODS
Non-trauma patients who received transfusion at the emergency department for 3 years from March 2009 to February 2011 were enrolled. The patients who are younger than 15 years, trauma patients, and transfused FFP or platelet alone are excluded. Medical records was investigated retrospectively. We investigated predictive factors for MT on non-trauma patients and predictive factors for mortality on MT patients.
RESULTS
Among 1655 non-trauma patients, 150 patients (9.24%) received MT. The age of MT group was younger than that of non-MT group and systolic bloor pressure, diastolic blood pressure, mean arterial pressure were significantly lower. Base excess, pH, lactate levels were significantly different between MT and non-MT group. Intensive care unit length of stay was longer, mortality of 24 hours was higher and survival discharge was lower than non-MT group. Mortality rate of MT group was 20.7% which was significantly higher than non-MT group's 9.3%. FFP:RBC ratio was higher in MT group than non-MT group. Among the MT group, non-survival group used higher FFP:RBC ratio product than survival group. On multivariate analysis, sBP, MAP, lactate, pH, BE were significant as predictors of MT.
CONCLUSION
For non-trauma patients in emergency department, if sBP, MAP, lactate, pH, BE are abnormal, massive transfusion could be expected. Like trauma patients, basic scoring system that can predict MT would be necessary and useful.

Keyword

Non-trauma; Massive blood transfusion; Prediction

MeSH Terms

Arterial Pressure
Blood Platelets
Blood Pressure
Blood Transfusion*
Emergencies*
Hemorrhage
Humans
Hydrogen-Ion Concentration
Intensive Care Units
Lactic Acid
Length of Stay
Medical Records
Mortality
Multivariate Analysis
Retrospective Studies
Risk Factors
Lactic Acid