M. Hamidi1, M. Zeeshan1, T. O’Keeffe1, A. Tang1, E. Zakaria1, A. Northcutt1, N. Kulvatunyou1, L. Gries1, B. Joseph1 1University Of Arizona,Trauma And Acute Care Surgery,Tucson, AZ, USA
Introduction:
Massive Transfusion (MT: >10pRBCs/24 hours) has revolutionized resuscitation during the last decade. However, its impact on geriatric patients remains unclear. The aim of our study was to assess the outcomes in geriatric trauma patients who received MT.
Methods:
We performed a 2-year (2013-2014) analysis of the TQIP and included all adult trauma patients who received MT. We stratified the patients into two groups; geriatrics (age≥65y), and non-geriatrics (age<65y). Outcome measures were blood products transfused within 24h and in-hospital mortality. Kaplan Maier and regression analysis were performed to control for demographics, injury and vital parameters.
Results:
We analyzed 416,104 trauma patients. 4236 patients received MT, of which 12% were geriatric patients. Median ISS was 22[10-34]. There was no difference in the ISS (p=0.57), blood products received (p=0.34) or type of hemorrhage control between the two groups (p=0.77). Geriatric patients who received MT had a high mortality (63% vs. 43%, p<0.001), were more likely to have a blunt injury (93% vs. 63%, p<0.001), and less likely to receive operative intervention (61% vs. 75%, p<0.001) compared to their younger counterpart. Fig1. In the geriatric group, the aOR was highest for patients aged≥80 (OR: 4.8 [2.9-7.8]) followed by age70-79 (OR: 2.4 [1.6-3.2]) when compared to age65-69y.
Conclusion:
Two thirds of the geriatric trauma patients who received massive transfusion died. Geriatric patients requiring MT had higher rate of blunt injuries and were less likely to undergo operative intervention compared to their younger counterpart. Revision of the MT criteria in geriatric patients may improve outcomes.
