Massive Transfusion in Pediatric Trauma: Analysis of the National Trauma Databank

Abstract Background Massive transfusion in pediatric trauma has been described in combat populations and other single institutions studies. We aim to define the incidence of massive transfusion in a large US civilian pediatric trauma population, identify predictive parameters of MT, and the mortality associated with massive transfusion. Methods Data from the National Trauma Databank (2010-2012), a trauma registry maintained by the American College of Surgeons, was analyzed. We included pediatric trauma patients ≤ 14 years that underwent massive transfusion, as defined by 40 ml/kg of blood products within the first 24 hours following admission. We compared the massive transfusion group with children receiving any transfusion within the same time frame. Univariate and multivariate analysis were performed. Results Of 356,583 pediatric trauma patients, 13,523 (4%) received any transfusion in the first 24 hours and 173 (0.04%) had a massive transfusion. On multivariate analysis, factors predicting massive transfusion were: older patients (5 to 12: OR 2.71, p=0.006, and ≥ 12: OR 5.14, p