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Assessing predictors of futility in patients receiving massive transfusions
- Source :
- TransfusionREFERENCES. 61(7)
- Publication Year :
- 2021
-
Abstract
- BACKGROUND Massive transfusions are associated with a high mortality rate, but there is little evidence indicating when such efforts are futile. The purpose of this study was to identify clinical variables that could be used as futility indicators in massively transfused patients. METHODS We retrospectively analyzed 138 adult surgical patients at our institution receiving a massive transfusion (2016-2019). Peak lactate and nadir pH within 24 h of massive transfusion initiation, along with other clinical variables, were assessed as predictors of the primary outcome, in-hospital mortality. RESULTS The overall rate of in-hospital mortality among our patient population was 52.9% (n = 73). Increasing lactate and decreasing pH were associated with greater mortality among massively transfused patients. Mortality rates were ~2-fold higher for patients in the highest lactate category (≥10.0 mmol/L: 25 of 37; 67.6%) compared to the lowest category (0.0-4.9 mmol/L: 17 of 48; 35.4%) (p = .005), and ~2.5-fold higher for patients in the lowest pH category (
- Subjects :
- Adult
Male
medicine.medical_specialty
Clinical variables
Immunology
Hospital Departments
030204 cardiovascular system & hematology
03 medical and health sciences
Young Adult
0302 clinical medicine
Primary outcome
Postoperative Complications
Internal medicine
medicine
Immunology and Allergy
Humans
In patient
Blood Transfusion
Hospital Mortality
Aged
Retrospective Studies
business.industry
Mortality rate
Age Factors
Hematology
Hydrogen-Ion Concentration
Middle Aged
Prognosis
Massive transfusion
Patient population
ROC Curve
Area Under Curve
Surgical Procedures, Operative
Lactates
Female
business
Medical Futility
Biomarkers
030215 immunology
Surgical patients
Subjects
Details
- ISSN :
- 15372995
- Volume :
- 61
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- TransfusionREFERENCES
- Accession number :
- edsair.doi.dedup.....0fa500e815099e08602c3e126aa7cdcf