dc.contributor.author | Rehn, M | en_US |
dc.contributor.author | Weaver, A | en_US |
dc.contributor.author | Brohi, K | en_US |
dc.contributor.author | Eshelby, S | en_US |
dc.contributor.author | Green, L | en_US |
dc.contributor.author | Røislien, J | en_US |
dc.contributor.author | Lockey, DJ | en_US |
dc.date.accessioned | 2018-07-17T13:20:40Z | |
dc.date.issued | 2019-03 | en_US |
dc.date.submitted | 2018-04-24T09:53:53.449Z | |
dc.identifier.uri | http://qmro.qmul.ac.uk/xmlui/handle/123456789/42284 | |
dc.description.abstract | BACKGROUND: Current management principles of hemorrhagic shock after trauma emphasize earlier transfusion therapy to prevent dilution of clotting factors and correct coagulopathy. London's Air Ambulance (LAA) was the first UK civilian prehospital service to routinely offer prehospital red blood cell (RBC) transfusion (phRTx). We investigated the effect of phRTx on mortality. METHODS: Retrospective trauma database study comparing mortality before implementation with after implementation of phRTx in exsanguinating trauma patients. Univariate logistic regression was performed for the unadjusted association between phRTx and mortality was performed, and multiple logistic regression adjusting for potential confounders. RESULTS: We identified 623 subjects with suspected major hemorrhage. We excluded 84 (13.5%) patients due to missing data on survival status. Overall 187 (62.3%) patients died in the before phRTx period and 143 (59.8%) died in the after phRTx group. There was no significant improvement in overall survival after the introduction of phRTx (P = 0.554). Examination of prehospital mortality demonstrated 126 deaths in the pre-phRTx group (42.2%) and 66 deaths in the RBC administered group (27.6%). There was a significant reduction in prehospital mortality in the group who received RBC (P < 0.001). CONCLUSIONS: phRTx was associated with increased survival to hospital, but not overall survival. The "delay death" effect of phRTx carries an impetus to further develop inhospital strategies to improve survival in severely bleeding patients. | en_US |
dc.description.sponsorship | The Norwegian Air Ambulance Foundation funded MR and JR expenses and publishing costs, but had no role in manuscript writing, study design, collection, analysis, or interpretation of data. | en_US |
dc.format.extent | 284 - 288 | en_US |
dc.language | eng | en_US |
dc.relation.ispartof | Shock | en_US |
dc.rights | This is the accepted version of this article. The final published version, Rehn, Marius, et al. "Effect of Pre-Hospital Red Blood Cell Transfusion on Mortality and Time of Death in Civilian Trauma Patients." Shock (Augusta, Ga.) (2018)., can be found here: https://doi.org/10.1097/SHK.0000000000001166 | |
dc.title | Effect of Prehospital Red Blood Cell Transfusion on Mortality and Time of Death in Civilian Trauma Patients. | en_US |
dc.type | Article | |
dc.rights.holder | Copyright © 2018 by the Shock Society. Unauthorized reproduction of this article is prohibited. | |
dc.identifier.doi | 10.1097/SHK.0000000000001166 | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/29664833 | en_US |
pubs.issue | 3 | en_US |
pubs.notes | Not known | en_US |
pubs.notes | Hi Laura, Library team. This is the accepted version that I have been sent by the authors, but I also note that it says "Copyright © 2018 by the Shock Society. Unauthorized reproduction of this article is prohibited." on the bottom of each page. So do I need to try to get hold of another version? Thanks. Tom Simpson (on behalf of Karim) | en_US |
pubs.publication-status | Published | en_US |
pubs.volume | 51 | en_US |