Dergiler / Ulusal Travma ve Acil Cerrahi Dergisi / 2020 / Cilt: 26 - Sayı: 6

Analysis of anatomical localization and severity of injury in patients with blood transfusion in urban terrain hospital

Saha hastanesinde kan transfüzyonu uygulanan hastalarda yaralanma şiddeti ve anatomik lokalizasyonunun analizi

Sayfa
937–942
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

This study presents the trauma of urban terrain conflict-related transfusion data from a UTH.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:BACKGROUND: Blood loss is the most significant cause of mortality in trauma cases.
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Temel Bulgular & Veri:The present study aims to analyze the blood/blood products requirement based on available data and find any associations between the transfusion requirements and injury severity scores (ISS) and anatomical locations of injuries of transfused patients.METHODS: Between 30 July 2014 and 30 July 2016, casualties admitted to the urban terrain hospital (UTH) and transfused at least one unit of red blood cell (RBC) were included.
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Sonuç & Katkı:This study presents the trauma of urban terrain conflict-related transfusion data from a UTH.
🔬Tür:Araştırma Makalesi
📍Kapsam:2014 Verileri
⚙️Değişkenler:Alan Parametreleri

Özet

BACKGROUND: Blood loss is the most significant cause of mortality in trauma cases. In injured patients, rapid evaluation and appropriate transfusion is lifesaving. The present study aims to analyze the blood/blood products requirement based on available data and find any associations between the transfusion requirements and injury severity scores (ISS) and anatomical locations of injuries of transfused patients.METHODS: Between 30 July 2014 and 30 July 2016, casualties admitted to the urban terrain hospital (UTH) and transfused at least one unit of red blood cell (RBC) were included. UTH Transfusion Record Notebook data included patients’ age, mechanism and anatomical location(s) of the injury, admission hemoglobin (g/dL) level, injury severity score (ISS), transfused units of erythrocyte suspension (ES), warm fresh whole blood (WFWB), fresh frozen plasma (FFP), and massive transfusion (MT) rate.RESULTS: In this study, all patients were male; the mean age was 28.7±7.8 years. Overall, 59 of 579 (10%) patients were transfused 458 units of RBC (ES+WFWB). Torso (thorax ± abdomen) injury was present in 61% of the casualties who underwent transfusion, and 93% of these patients underwent massive transfusion. In 71% of patients, the ISS was >15, and there was statistically significant high blood/blood products use and MT rate in these patients, respectively (p=0.021, p=0.006).CONCLUSION: Anatomical location of injuries and ISS are valuable in the rapid determining of MT and survival rates of casualties. Especially in torso injuries, bleeding control is difficult and transfusion requirement and mortality rates are high. This study presents the trauma of urban terrain conflict-related transfusion data from a UTH.

Abstract

AMAÇ: Travma olgularında en önemli mortalite nedeni kanamadır. Yaralıların hızlı değerlendirmesi ve uygun transfüzyonu hayat kurtarıcıdır. Bu çalışmanın amacı, mevcut verilere dayanarak, kan/kan ürünü transfüzyon deneyimlerini analiz etmek, transfüzyon gereksinimi ile yaralanma şiddeti skoru (injury severity score-ISS), ve yaralanma bölgesinin anatomik yerleşimi arasında ilişkiyi değerlendirmektir.GEREÇ VE YÖNTEM: Çalışmaya 30 Temmuz 2014–30 Temmuz 2016 tarihleri arasında, saha hastanesine başvuran ve en az bir ünite kan/kan ürünü transfüzyonu yapılan yaralılar alındı. Hastane transfüzyon kayıt defterinden, hastaların yaşı, yaralanma mekanizması, yaralanmanın anatomik yerleşimi, hastaneye kabul hemoglobin (g/dL) değeri, ISS, transfüze edilmiş eritrosit süspansiyonu, sıcak taze tam kan, taze donmuş plazma gibi kan ürünleri miktarı ve masif transfüzyon (MT) oranı ile ilgili veriler elde edildi.BULGULAR: Tüm hastalar erkekti, ortalama yaş 28.7±7.8 yıl idi. Toplamda 579 hastadan 59’una (%10) 458 ünite RBC (ES+WFWB) transfüzyonu yapıldı. Transfüzyon uygulanan yaralıların %61’inde gövde (toraks±karın) yaralanması vardı ve bu hastaların %93’üne masif transfüzyon uygulandı. Hastaların % 71’inde ISS >15 idi ve bu hastalarda istatistiksel olarak anlamlı yüksek kan/kan ürünleri kullanımı ve MT oranı vardı (p=0.021, p=0.006).TARTIŞMA: Yaralanmaların ve ISS’nin anatomik yeri, MT’nin hızlı bir şekilde belirlenmesinde ve kazazedelerin hayatta kalma oranlarında değerlidir. Özellikle gövde yaralanmalarında kanama kontrolü zordur ve transfüzyon gereksinimi ve mortalite oranları yüksektir. Ayrıca bu makale bir saha hastanesindeki, kentsel arazi çatışmasıyla ilgili transfüzyon verilerini sunmaktadır.

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Bu Makaleye Atıf Yap

EKSERT, S., ÜNLÜ, A., AYDIN, F. N., KAYA, M., AŞIK, M. B., KANTEMİR, A., ÖZTAŞ, M., KEKLİKCİ, K., SİR, E. (2020). Analysis of anatomical localization and severity of injury in patients with blood transfusion in urban terrain hospital. Ulusal Travma ve Acil Cerrahi Dergisi, Cilt: 26 - Sayı: 6, 937–942. https://ajindex.com/articles/323511

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Kaynakça (11)

  1. Holcomb JB, del Junco DJ, Fox EE, Wade CE, Cohen MJ, Schreiber MA, et al. The prospective, observational, multicenter, major trauma transfusion (PROMMTT) study: comparative effectiveness of a time-varying treatment with competing risks. JAMA Surg 2013;148:127–36
  2. Buehner MF, Eastridge BJ, Aden JK, DuBose JJ, Blackbourne LH, Cestero RF. Combat Casualties and Severe Shock: Risk Factors for Death at Role 3 Military Facilities. Mil Med 2017;182:e1922–8
  3. Eastridge BJ, Mabry RL, Seguin P, Cantrell J, Tops T, Uribe P, Mallett O, et al. Death on the battlefield (2001-2011): implications for the future of combat casualty care. J Trauma Acute Care Surg 2012;73:S431–7
  4. Ünlü A, Cetinkaya RA, Ege T, Ozmen P, Hurmeric V, Ozer MT, et al. Role 2 military hospitals: results of a new trauma care concept on 170 casualties. Eur J Trauma Emerg Surg 2015;41:149–55
  5. Aşık MB, Akay S, Eksert S. Analyses of combat-related injuries to maxillofacial and cervical regions and experiences in an operational field hospital. Ulus Travma Acil Cerrahi Derg 2018;24:56–60
  6. Güven HE, Bilge S, Aydın AA, Eryılmaz M. Comparison of the non-mortal gunshot and handmade explosive blast traumas during a low-intensity conflict on urban terrain. Turk J Surg 2018;34:221–4
  7. Eryılmaz M, Tezel O, Taş H, Arzıman I, Oğünç GI, Kaldırım U, et al. The relationship between Injury Severity Scores and transfusion requirements of 108 consecutive cases injured with high kinetic energy weapons: a tertiary center end-mode mortality analysis. Ulus Travma Acil Cerrahi Derg 2014;20:39–44
  8. Javali RH, Krishnamoorthy, Patil A, Srinivasarangan M, Suraj, Sriharsha. Comparison of Injury Severity Score, New Injury Severity Score, Revised Trauma Score and Trauma and Injury Severity Score for Mortality Prediction in Elderly Trauma Patients. Indian J Crit Care Med 2019;23:73–7
  9. Nunez TC, Voskresensky IV, Dossett LA, Shinall R, Dutton WD, Cotton BA. Early prediction of massive transfusion in trauma: simple as ABC (assessment of blood consumption)?. J Trauma 2009;66:346–52
  10. Bellamy RF. Combat trauma overview. In: Zatchuk R, Grande CM, editors. Textbook of Military Medicine, Anesthesia and Perioperative Care of the Combat Casualty. Falls Church, VA: Office of the Surgeon General, United States Army;1995.p.1–42
  11. Maddry JK, Perez CA, Mora AG, Lear JD, Savell SC, Bebarta VS. Impact of prehospital medical evacuation (MEDEVAC) transport time on combat mortality in patients with non-compressible torso injur