Transfusion futility thresholds and mortality in geriatric trauma: Does frailty matter?

被引：5

作者：

L'Huillier, Joseph C. ^{[1
,2
]}

Hua, Shuangcheng ^{[3
]}

Logghe, Heather J. ^{[1
]}

Yu, Jihnhee ^{[3
]}

Myneni, Ajay A. ^{[1
]}

Noyes, Katia ^{[1
,2
]}

Guo, Weidun A. ^{[1
,4
]}

机构：

[1] Univ Buffalo, Jacobs Sch Med & Biomed Sci, Dept Surg, Buffalo, NY 14203 USA

[2] Univ Buffalo, Sch Publ Hlth & Hlth Profess, Dept Epidemiol & Environm Hlth, Div Hlth Serv Policy & Practice, Buffalo, NY 14203 USA

[3] Univ Buffalo, Sch Publ Hlth & Hlth Profess, Dept Biostat, Buffalo, NY 14203 USA

[4] Erie Cty Med Ctr & Labs, 462 Grider St, Buffalo, NY 14215 USA

来源：

AMERICAN JOURNAL OF SURGERY | 2024年 / 228卷

关键词：

Blood transfusion; Transfusion futility threshold; Geriatric; Frailty; TQIP; MASSIVE TRANSFUSION; BLUNT TRAUMA; OUTCOMES; INDEX; PROTOCOL; SURGERY; EPIDEMIOLOGY; ASSOCIATION; GUIDELINES; SURVIVAL;

D O I：

10.1016/j.amjsurg.2023.08.020

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: Data on massive transfusion (MT) in geriatric trauma patients is lacking. This study aims to determine geriatric transfusion futility thresholds (TT) and TT variations based on frailty. Methods: Patients from 2013 to 2018 TQIP database receiving MT were stratified by age and frailty. TTs and outcomes were compared between geriatric and younger adults and among geriatric adults based on frailty status. Results: The TT was lower for geriatric than younger adults (34 vs 39 units; p = 0.03). There was no difference in TT between the non-frail, frail, and severely frail geriatric adults (37, 30 and 25 units, respectively, p > 0.05). Geriatric adults had higher mortality than younger adults (63.1% vs 45.8%, p < 0.01). Non-frail geriatric adults had the highest mortality (69.4% vs 56.5% vs 56.2%, p < 0.01). Conclusions: Geriatric patients have a lower TT than younger adults, irrespective of frailty. This may help improve outcomes and optimize MT utilization.

引用

页码：113 / 121

页数：9

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