Descriptive characteristics and in-hospital mortality of critically bleeding patients requiring massive transfusion

Results from the Australian and New Zealand Massive Transfusion Registry

R. Ruseckaite, Z. K. McQuilten, J. C. Oldroyd, T. H. Richter, P. A. Cameron, J. P. Isbister, E. M. Wood

Research output: Contribution to journalArticleResearchpeer-review

8 Citations (Scopus)

Abstract

Background and Objectives: Critically bleeding patients requiring massive transfusion (MT) are clinically challenging, and limited data exist to support management decisions. This study describes patient characteristics, transfusion support and clinical outcomes from the Australian and New Zealand (NZ) Massive Transfusion Registry (ANZ-MTR). Materials and Methods: Retrospective, cohort study of all adult patients receiving MT (≥5 units red blood cells [RBC] in 4 h) at participating ANZ-MTR hospitals, 2011-2015. Mortality information was collected from the Australian National Death Index and NZ Ministry of Health. Associations between patient characteristics and outcomes were modelled using logistic regression. Results: A total of 3560 MT cases were identified. For in-hospital deaths, cardiothoracic surgery was the most frequent bleeding context (24·5%) followed by trauma (18·3%). Age (OR = 1·03; 95% CI: 1·02-1·04), more comorbidities (OR = 1·14; 95% CI: 1·09-1·21), larger volume of RBC in first 24 h from MT onset (OR = 1·04; 95% CI: 1·02-1·06), higher platelet to RBC ratio at 4 h (OR = 2·76; 95% CI: 1·14-6·65) and higher activated partial thromboplastin time (OR = 1·02; 95% CI: 1·01-1·03) were associated with in-hospital mortality. Conclusion: Patients with more comorbidities, older age, traumatic or surgical bleeding or requiring more blood components had higher in-hospital mortality. These findings provide a basis to evaluate and monitor practice relating to optimal use of blood products, variation in transfusion practices and patient outcomes, and also enable benchmarking of hospital performance for management of MT in specific patient groups.

Original languageEnglish
Pages (from-to)240-248
Number of pages9
JournalVox Sanguinis
Volume112
Issue number3
DOIs
Publication statusPublished - Apr 2017

Keywords

  • Critical bleeding
  • Massive transfusion
  • Mortality
  • Registry

Cite this

@article{e496939cc752423c9ae1371290200db0,
title = "Descriptive characteristics and in-hospital mortality of critically bleeding patients requiring massive transfusion: Results from the Australian and New Zealand Massive Transfusion Registry",
abstract = "Background and Objectives: Critically bleeding patients requiring massive transfusion (MT) are clinically challenging, and limited data exist to support management decisions. This study describes patient characteristics, transfusion support and clinical outcomes from the Australian and New Zealand (NZ) Massive Transfusion Registry (ANZ-MTR). Materials and Methods: Retrospective, cohort study of all adult patients receiving MT (≥5 units red blood cells [RBC] in 4 h) at participating ANZ-MTR hospitals, 2011-2015. Mortality information was collected from the Australian National Death Index and NZ Ministry of Health. Associations between patient characteristics and outcomes were modelled using logistic regression. Results: A total of 3560 MT cases were identified. For in-hospital deaths, cardiothoracic surgery was the most frequent bleeding context (24·5{\%}) followed by trauma (18·3{\%}). Age (OR = 1·03; 95{\%} CI: 1·02-1·04), more comorbidities (OR = 1·14; 95{\%} CI: 1·09-1·21), larger volume of RBC in first 24 h from MT onset (OR = 1·04; 95{\%} CI: 1·02-1·06), higher platelet to RBC ratio at 4 h (OR = 2·76; 95{\%} CI: 1·14-6·65) and higher activated partial thromboplastin time (OR = 1·02; 95{\%} CI: 1·01-1·03) were associated with in-hospital mortality. Conclusion: Patients with more comorbidities, older age, traumatic or surgical bleeding or requiring more blood components had higher in-hospital mortality. These findings provide a basis to evaluate and monitor practice relating to optimal use of blood products, variation in transfusion practices and patient outcomes, and also enable benchmarking of hospital performance for management of MT in specific patient groups.",
keywords = "Critical bleeding, Massive transfusion, Mortality, Registry",
author = "R. Ruseckaite and McQuilten, {Z. K.} and Oldroyd, {J. C.} and Richter, {T. H.} and Cameron, {P. A.} and Isbister, {J. P.} and Wood, {E. M.}",
year = "2017",
month = "4",
doi = "10.1111/vox.12487",
language = "English",
volume = "112",
pages = "240--248",
journal = "Vox Sanguinis",
issn = "0042-9007",
publisher = "Wiley-Blackwell",
number = "3",

}

Descriptive characteristics and in-hospital mortality of critically bleeding patients requiring massive transfusion : Results from the Australian and New Zealand Massive Transfusion Registry. / Ruseckaite, R.; McQuilten, Z. K.; Oldroyd, J. C.; Richter, T. H.; Cameron, P. A.; Isbister, J. P.; Wood, E. M.

In: Vox Sanguinis, Vol. 112, No. 3, 04.2017, p. 240-248.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Descriptive characteristics and in-hospital mortality of critically bleeding patients requiring massive transfusion

T2 - Results from the Australian and New Zealand Massive Transfusion Registry

AU - Ruseckaite, R.

AU - McQuilten, Z. K.

AU - Oldroyd, J. C.

AU - Richter, T. H.

AU - Cameron, P. A.

AU - Isbister, J. P.

AU - Wood, E. M.

PY - 2017/4

Y1 - 2017/4

N2 - Background and Objectives: Critically bleeding patients requiring massive transfusion (MT) are clinically challenging, and limited data exist to support management decisions. This study describes patient characteristics, transfusion support and clinical outcomes from the Australian and New Zealand (NZ) Massive Transfusion Registry (ANZ-MTR). Materials and Methods: Retrospective, cohort study of all adult patients receiving MT (≥5 units red blood cells [RBC] in 4 h) at participating ANZ-MTR hospitals, 2011-2015. Mortality information was collected from the Australian National Death Index and NZ Ministry of Health. Associations between patient characteristics and outcomes were modelled using logistic regression. Results: A total of 3560 MT cases were identified. For in-hospital deaths, cardiothoracic surgery was the most frequent bleeding context (24·5%) followed by trauma (18·3%). Age (OR = 1·03; 95% CI: 1·02-1·04), more comorbidities (OR = 1·14; 95% CI: 1·09-1·21), larger volume of RBC in first 24 h from MT onset (OR = 1·04; 95% CI: 1·02-1·06), higher platelet to RBC ratio at 4 h (OR = 2·76; 95% CI: 1·14-6·65) and higher activated partial thromboplastin time (OR = 1·02; 95% CI: 1·01-1·03) were associated with in-hospital mortality. Conclusion: Patients with more comorbidities, older age, traumatic or surgical bleeding or requiring more blood components had higher in-hospital mortality. These findings provide a basis to evaluate and monitor practice relating to optimal use of blood products, variation in transfusion practices and patient outcomes, and also enable benchmarking of hospital performance for management of MT in specific patient groups.

AB - Background and Objectives: Critically bleeding patients requiring massive transfusion (MT) are clinically challenging, and limited data exist to support management decisions. This study describes patient characteristics, transfusion support and clinical outcomes from the Australian and New Zealand (NZ) Massive Transfusion Registry (ANZ-MTR). Materials and Methods: Retrospective, cohort study of all adult patients receiving MT (≥5 units red blood cells [RBC] in 4 h) at participating ANZ-MTR hospitals, 2011-2015. Mortality information was collected from the Australian National Death Index and NZ Ministry of Health. Associations between patient characteristics and outcomes were modelled using logistic regression. Results: A total of 3560 MT cases were identified. For in-hospital deaths, cardiothoracic surgery was the most frequent bleeding context (24·5%) followed by trauma (18·3%). Age (OR = 1·03; 95% CI: 1·02-1·04), more comorbidities (OR = 1·14; 95% CI: 1·09-1·21), larger volume of RBC in first 24 h from MT onset (OR = 1·04; 95% CI: 1·02-1·06), higher platelet to RBC ratio at 4 h (OR = 2·76; 95% CI: 1·14-6·65) and higher activated partial thromboplastin time (OR = 1·02; 95% CI: 1·01-1·03) were associated with in-hospital mortality. Conclusion: Patients with more comorbidities, older age, traumatic or surgical bleeding or requiring more blood components had higher in-hospital mortality. These findings provide a basis to evaluate and monitor practice relating to optimal use of blood products, variation in transfusion practices and patient outcomes, and also enable benchmarking of hospital performance for management of MT in specific patient groups.

KW - Critical bleeding

KW - Massive transfusion

KW - Mortality

KW - Registry

UR - http://www.scopus.com/inward/record.url?scp=85013130646&partnerID=8YFLogxK

U2 - 10.1111/vox.12487

DO - 10.1111/vox.12487

M3 - Article

VL - 112

SP - 240

EP - 248

JO - Vox Sanguinis

JF - Vox Sanguinis

SN - 0042-9007

IS - 3

ER -