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• W2912113093 abstract "Purpose The purpose of this study was to identify an optimal definition of massive transfusion (MT) in civilian pediatric trauma. Methods Severely injured children (age ≤18 years, injury severity score ≥25) in the Trauma Quality Improvement Program research datasets 2014–2015 that received blood products were identified. Children with traumatic brain injury and non-survivable injuries were excluded. Early mortality was defined as death within 24 h and delayed mortality as death after 24 h from hospital admission. Receiver operating curves and sensitivity and specificity analysis identified an MT threshold. Continuous variables are presented as median [IQR]. Results Of the 270 included children, the overall mortality was 27% (N = 74). There were no differences in demographics or mechanism of injury between children that lived or died. Sensitivity and specificity for early mortality was optimized at a 4-h transfusion volume of 37 ml/kg. After controlling for other significant variables, a threshold of 37 ml/kg/4 h predicted the need for a hemorrhage control procedure (OR 8.60; 95% CI 4.25–17.42; p < 0.01) and early mortality (OR 4.24; 95% CI 1.96–9.16; p < 0.01). Conclusion An MTP threshold of 37 mL/kg/4 h of transfused blood products predicted the need for hemorrhage control procedures and early mortality. This threshold may provide clinicians with a timely prognostic indicator, improve research methodology, and resource utilization. Type of Study Diagnostic Test. Level of Evidence III." @default.
• W2912113093 created "2019-02-21" @default.
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• W2912113093 date "2019-05-01" @default.
• W2912113093 modified "2023-09-26" @default.
• W2912113093 title "Defining massive transfusion in civilian pediatric trauma" @default.
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• W2912113093 doi "https://doi.org/10.1016/j.jpedsurg.2019.01.029" @default.
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