Massive Blood Transfusions and Outcomes in Trauma Patients; An Intention to Treat Analysis

Objective: to determine if there exists an upper limit for amount of blood transfused in trauma patients before it reaches a point of futility. methods: a prospective cohort study was conducted on 131 patients who received massive blood transfusion (mbt), defined as 10 u or higher of prbcs received in the initial 24 hours. data collected from a level ii trauma center registry were used to analyze reports of adult patients from july 2014 to 2017. cohorts were divided by amount of blood received - 0 to 9 u, 10-19 u, 20 to 29 u, 30-39 u, 40 u or higher - odds ratio for mortality and p-values for mean injury severity score and overall hospital length of stay were calculated for each group. results: odds ratios for massive blood transfusion groups from 10 units to 39 units each contained the null value, while our 40 units and above group did not (or 12.52, 95% ci 1.3-117.7). conclusion: although this study is limited by its sample size, these results suggests that 40 units of prbcs may be a threshold at which survival rates begin to decrease significantly.