N. K. Dhillon1, E. J. Smith1, A. Ko1, M. Y. Harada1, K. Patel1, M. Scheipe1, G. Barmparas1, E. J. Ley1 1Cedars-Sinai Medical Center,Los Angeles, CA, USA
Introduction: Massive Transfusion Protocol (MTP) is often initiated in patients who are unstable secondary to hemorrhagic shock. Thrombotic events have been associated with MTP, however the risk factors for the development of venous thromboembolism (VTE) within this patient population is unknown.
Methods: A retrospective review was conducted by examining the electronic medical records of all trauma patients admitted to a Level I trauma center who had MTP initiated from 2011 to 2015. Data was collected on patient demographics, mechanism of injury, injury severity scores, quantity of packed red blood cells (PRBC) transfused during MTP activation, incidence of VTE, ICU length of stay (LOS), hospital LOS, and ventilator days.
Results: Of the 63 patients identified who had MTP activated, 11 (17.5%) developed a VTE during their hospital admission. One patient was diagnosed with a pulmonary embolus. Patients who developed VTE were compared to those who did not. Age (40 (22-62) vs. 42.5 (25.5-54) years, p=0.94), sex (46% vs. 73% male, p=0.09), and mechanism of injury (59% vs. 64% blunt, p=1.0) were similar. ICU LOS, hospital LOS, and ventilator days were longer in the patients who were diagnosed with a VTE (Table 1). Multivariable analysis revealed an increase in the odds for developing a VTE with each unit of PRBC transfused (AOR=1.17, p=0.011).
Conclusion: Patients who received PRBC after MTP activation were at higher risk for developing VTE. Clinicians may need a higher suspicion for the presence of VTE within this patient population.
