Efecto de la transfusión sanguínea en la mortalidad en politraumatismo

Abstract

IntroductionManagement of trauma patient is the greatest challenge in orthopaedic emergency care. Its proper diagnosis and early management, including blood transfusion, is critical for patient outcome. Materials and methodsA prospective cohort study was conducted on all multiple injury patients between 18 and 59 years old admitted to the San José Hospital and University Children's San José Hospital with multiple trauma (ISS>17). They were followed-up until either discharge or death. Their demographic and clinical data were analysed in a database using descriptive statistics. ResultsA total of 97 patients were included, with mean age 38 years ± 12. The distribution multiple trauma was mild (78, 80%), moderate (12, 12%), and severe (7, 8%). All trauma patients suffered damage to limbs and pelvis, 75 (77%) closed brain trauma, 60 (61%) abdominal-pelvic, and 57 (58%) cardiovascular. Trauma causes included accidents (71, 73%), or falling from height (28, 27%). Initial haemoglobin was 12.8g/dl ± 2.1. There were more patients admitted to ICU in the transfusion group <6 h versus >24 h (68% vs 37%), but lower mortality (0% vs 60%). The mortality in the severe multiple injuries group was 85%. As the transfusion volume received increased, so did the number of patients in ICU. Among those who died, the highest proportion received transfusion (83% vs 17%). ConclusionHigher mortality was found among those patients transfused and in those who received a late transfusion. Evidence level: II.