Prediction of massive transfusion in trauma patients in the surgical intensive care units (THAI-SICU study)

© 2019 Chinese Medical Association Purpose: After damage control surgery, trauma patients are transferred to intensive care units to restore the physiology. During this period, massive transfusion might be required for ongoing bleeding and coagulopathy. This research aimed to identify predictors of...

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Main Authors: Osaree Akaraborworn, O. Chaiwat, Sunisa Chatmongkolchart, Chanatthee Kitsiripant, Kaweesak Chittawatanarat, Sunthiti Morakul, Thammasak Thawitsri, P. Wacharasint, Sujaree Poopipatpab, Waraporn Chau-In, Chaiyapruk Kusumaphanyo
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Published: 2019
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/65712
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-657122019-08-05T04:39:58Z Prediction of massive transfusion in trauma patients in the surgical intensive care units (THAI-SICU study) Osaree Akaraborworn O. Chaiwat Sunisa Chatmongkolchart Chanatthee Kitsiripant Kaweesak Chittawatanarat Sunthiti Morakul Thammasak Thawitsri P. Wacharasint Sujaree Poopipatpab Waraporn Chau-In Chaiyapruk Kusumaphanyo Medicine © 2019 Chinese Medical Association Purpose: After damage control surgery, trauma patients are transferred to intensive care units to restore the physiology. During this period, massive transfusion might be required for ongoing bleeding and coagulopathy. This research aimed to identify predictors of massive blood transfusion in the surgical intensive care units (SICUs). Methods: This is an analysis of the THAI-SICU study which was a prospective cohort that was done in the 9-university-based SICUs in Thailand. The study included only patients admitted due to trauma mechanisms. Massive transfusion was defined as received ≥10 units of packed red blood cells on the first day of admission. Patient characteristics and physiologic data were analyzed to identify the potential factors. A multivariable regression was then performed to identify the significant model. Results: Three hundred and seventy patients were enrolled. Sixteen patients (5%) received massive transfusion in the SICUs. The factors that significantly predicted massive transfusion were an initial sequential organ failure assessment (SOFA) ≥9 (risk difference (RD) 0.13, 95% confidence interval (CI): 0.03–0.22, p = 0.01); intra-operative blood loss ≥ 4900 mL (RD 0.33, 95% CI: 0.04–0.62, p = 0.02) and intra-operative blood transfusion ≥ 10 units (RD 0.45, 95% CI: 0.06 to 0.84, p = 0.02). The probability to have massive transfusion was 0.976 in patients who had these 3 factors. Conclusion: Massive blood transfusion in the SICUs occurred in 5%. An initial SOFA ≥9, intra-operative blood loss ≥4900 mL, and intra-operative blood transfusion ≥10 units were the significant factors to predict massive transfusion in the SICUs. 2019-08-05T04:39:58Z 2019-08-05T04:39:58Z 2019-08-01 Journal 10081275 2-s2.0-85067517138 10.1016/j.cjtee.2019.04.004 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85067517138&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/65712
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Osaree Akaraborworn
O. Chaiwat
Sunisa Chatmongkolchart
Chanatthee Kitsiripant
Kaweesak Chittawatanarat
Sunthiti Morakul
Thammasak Thawitsri
P. Wacharasint
Sujaree Poopipatpab
Waraporn Chau-In
Chaiyapruk Kusumaphanyo
Prediction of massive transfusion in trauma patients in the surgical intensive care units (THAI-SICU study)
description © 2019 Chinese Medical Association Purpose: After damage control surgery, trauma patients are transferred to intensive care units to restore the physiology. During this period, massive transfusion might be required for ongoing bleeding and coagulopathy. This research aimed to identify predictors of massive blood transfusion in the surgical intensive care units (SICUs). Methods: This is an analysis of the THAI-SICU study which was a prospective cohort that was done in the 9-university-based SICUs in Thailand. The study included only patients admitted due to trauma mechanisms. Massive transfusion was defined as received ≥10 units of packed red blood cells on the first day of admission. Patient characteristics and physiologic data were analyzed to identify the potential factors. A multivariable regression was then performed to identify the significant model. Results: Three hundred and seventy patients were enrolled. Sixteen patients (5%) received massive transfusion in the SICUs. The factors that significantly predicted massive transfusion were an initial sequential organ failure assessment (SOFA) ≥9 (risk difference (RD) 0.13, 95% confidence interval (CI): 0.03–0.22, p = 0.01); intra-operative blood loss ≥ 4900 mL (RD 0.33, 95% CI: 0.04–0.62, p = 0.02) and intra-operative blood transfusion ≥ 10 units (RD 0.45, 95% CI: 0.06 to 0.84, p = 0.02). The probability to have massive transfusion was 0.976 in patients who had these 3 factors. Conclusion: Massive blood transfusion in the SICUs occurred in 5%. An initial SOFA ≥9, intra-operative blood loss ≥4900 mL, and intra-operative blood transfusion ≥10 units were the significant factors to predict massive transfusion in the SICUs.
format Journal
author Osaree Akaraborworn
O. Chaiwat
Sunisa Chatmongkolchart
Chanatthee Kitsiripant
Kaweesak Chittawatanarat
Sunthiti Morakul
Thammasak Thawitsri
P. Wacharasint
Sujaree Poopipatpab
Waraporn Chau-In
Chaiyapruk Kusumaphanyo
author_facet Osaree Akaraborworn
O. Chaiwat
Sunisa Chatmongkolchart
Chanatthee Kitsiripant
Kaweesak Chittawatanarat
Sunthiti Morakul
Thammasak Thawitsri
P. Wacharasint
Sujaree Poopipatpab
Waraporn Chau-In
Chaiyapruk Kusumaphanyo
author_sort Osaree Akaraborworn
title Prediction of massive transfusion in trauma patients in the surgical intensive care units (THAI-SICU study)
title_short Prediction of massive transfusion in trauma patients in the surgical intensive care units (THAI-SICU study)
title_full Prediction of massive transfusion in trauma patients in the surgical intensive care units (THAI-SICU study)
title_fullStr Prediction of massive transfusion in trauma patients in the surgical intensive care units (THAI-SICU study)
title_full_unstemmed Prediction of massive transfusion in trauma patients in the surgical intensive care units (THAI-SICU study)
title_sort prediction of massive transfusion in trauma patients in the surgical intensive care units (thai-sicu study)
publishDate 2019
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85067517138&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/65712
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