Background This study evaluated the effectiveness and clinical outcomes of the implementation of a trauma center and massive transfusion protocol (TCMTP) in a developing country without a well-established trauma system. Methods We included patients (1) aged [15 years, (2) with an Injury Severity Score [15, (3) who received C10 units of packed red blood cells (PRBCs) within 24 h, (4) who directly visited our institution from 2010 to 2016, and (5) who survived for C24 h. Patients treated during the post-TCMTP period (2015–2016) were compared with historical groups treated pre-TCMTP (2010–2012) and interim-TCMTP (2013–2014). Demographics, transfusion and ﬂuid therapy performance, and clinical outcomes were compared between the three groups. Results Overall, 190 patients were included: 64, 64, and 62 patients in the pre-TCMTP, interim-TCMTP, and post- TCMTP groups, respectively. Comparison between the three groups revealed signiﬁcant differences in the fresh- frozen plasma/PRBC ratio (p = 0.001) and crystalloid infusion (p = 0.007); these variables gradually increased from pre- to post-TCMTP. Conversely, colloid infusion showed a reduction post-TCMTP (p \ 0.001). Kaplan–Meier curves revealed that the 90-day survival rate was signiﬁcantly higher in the post-TCMTP group (pre-TCMTP: 45.3 vs. 75.8%, p = 0.001; interim-TCMTP: 56.3 vs. 75.8%, p = 0.027).
World Journal of Surgery – Springer Journals
Published: Dec 31, 2017
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