ANALYSIS OF PATIENTS WHO UNDERWENT MODERATE-TO-MASSIVE TRANSFUSION AT A TOKYO METROPOLITAN HOSPITAL

Abstract

Recently, the method used for massive transfusion has changed worldwide. We retrospectively reviewed 168 patients who underwent transfusion with more than 10 units of red blood cell concentrate (RCC) between January 2006 and June 2009 (1 unit=140ml [in Japan]). Of these patients, we studied 65 patients in particular; these patients had multiple injuries and had received moderate-to-massive blood transfusion with more than 10 RCC units within 24 hours of arriving at the hospital.
Hospital mortality of the patients with multiple injuries was 60%, and was independently associated with risk factors such as age, activated partial thromboplastin time (aPTT), and plasma fibrin/fibrinogen degradation product (FDP) value.
The 24-hour mortality rate of the group that was not transfused with fresh frozen plasma (FFP) was 90.0%. Mortality in the FFP: RCC ratio 0.5 or less group was 68.4%, but in contrast was 47.2% in the higher ratio group. These results suggest that the transfusion ratio is important with respect to initial transfusion treatment and that a separate protocol should be created at our hospital for massive transfusion.