Massive blood transfusion and outcome in 1062 polytrauma patients: a prospective study based on the Trauma Registry of the German Trauma Society

Background and Objectives About 15% of polytrauma patients receive massive blood transfusion (MBT) defined as ≥ 10 units of packed red blood cells (PRBC). In general, the prognosis of trauma patients receiving MBT is considered to be poor. The purpose of this study was to investigate the impact of MBT on the outcome of polytrauma patients. Materials and Methods Records of 10 997 patients in the Trauma Registry of the German Trauma Society were analysed. Transfusion data were available from 8182 severe trauma patients with a mean injury severity score of 24·5 and, of these 8182 patients, 1062 received 10 units of PRBC. First, a logistic regression model for the predictors of mortality was performed. Second, incidences of organ failure and sepsis as well as survival rates were analysed. Results The highest risk for mortality was age over 55 years (odds ratios [OR] 4·7; confidence intervals [CI 95%], 3·5–6·5) followed by Glasgow Coma Scale 8 (OR 4·6; 3·4–6·1), MBT 20 units of PRBC (OR 3·3; 2·1–5·4), thromboplastin time