Ten-year evolution of a massive transfusion protocol in a level 1 trauma centre: have outcomes improved?

Abstract:

BACKGROUND:We aimed to evaluate the evolution and implementation of the massive transfusion protocol (MTP) in an urban level 1 trauma centre. Most data on this topic comes from trauma centres with high exposure to life-threatening haemorrhage. This study examines the effect of the introduction of an MTP in an Australian level 1 trauma centre. METHODS:A retrospective study of prospectively collected data was performed over a 14-year period. Three groups of trauma patients, who received more than 10 units of packed red blood cells (PRBC), were compared: a pre-MTP group (2002-2006), an MTP-I group (2006-2010) and an MTP-II group (2010-2016) when the protocol was updated. Key outcomes were mortality, complications and number of blood products transfused. RESULTS:A total of 168 patients were included: 54 pre-MTP patients were compared to 47 MTP-I and 67 MTP-II patients. In the MTP-II group, fewer units of PRBC and platelets were administered within the first 24 h: 17 versus 14 (P = 0.01) and 12 versus 8 (P < 0.001), respectively. Less infections were noted in the MTP-I group: 51.9% versus 31.9% (P = 0.04). No significant differences were found regarding mortality, ventilator days, intensive care unit and total hospital lengths of stay. CONCLUSION:Introduction of an MTP-II in our level 1 civilian trauma centre significantly reduced the amount of PRBC and platelets used during damage control resuscitation. Introduction of the MTP did not directly impact survival or the incidence of complications. Nevertheless, this study reflects the complexity of real-life medical care in a level 1 civilian trauma centre.

journal_name

ANZ J Surg

journal_title

ANZ journal of surgery

authors

van der Meij JE,Geeraedts LMG Jr,Kamphuis SJM,Kumar N,Greenfield T,Tweeddale G,Rosenfeld D,D'Amours SK

doi

10.1111/ans.15416

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

1470-1474

issue

11

eissn

1445-1433

issn

1445-2197

journal_volume

89

pub_type

杂志文章
  • Internal pancreatic fistulas with pancreatic ascites and pancreatic pleural effusions: recognition and management.

    abstract:BACKGROUND:Internal pancreatic fistulas are well recognized complications of chronic pancreatitis. METHODS:Six patients with internal pancreatic fistulas were treated over a period of 5 years from 1995 to 1999. Four patients presented with ascites, one patient presented with ascites and bilateral pleural effusion and ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1440-1622.2001.02077.x

    authors: Kaman L,Behera A,Singh R,Katariya RN

    更新日期:2001-04-01 00:00:00

  • Dorsal lumbotomy incision in paediatric pyeloplasty.

    abstract:BACKGROUND:The purpose of the present study was to comprehensively assess the results of surgical management of pelvi-ureteric junction (PUJ) obstruction using lumbotomy as the surgical approach. METHODS:Records of 36 consecutive patients with unilateral PUJ obstruction who underwent pyeloplasty in the last 5 years we...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-1433.2004.03032.x

    authors: Bajpai M,Kumar A,Tripathi M,Bal CS

    更新日期:2004-06-01 00:00:00

  • Timeliness and outcomes of carotid endarterectomy for symptomatic carotid artery stenosis: a single centre audit.

    abstract:BACKGROUND:For patients presenting with symptomatic internal carotid artery stenosis, carotid endarterectomy (CEA) surgery is recommended to be performed generally within a 48-hr to 14-day window. This study aimed to assess timeliness of delivery, and outcomes, of CEA surgery in a tertiary vascular centre. METHOD:Pati...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15757

    authors: Lim ETA,Laws PE,Beresford TP,Khanafer AMA,Roake JA

    更新日期:2020-03-01 00:00:00

  • Early outcomes of implanting larger-sized grafts in deceased donor liver transplantation.

    abstract:BACKGROUND:The outcomes of large-sized graft mismatch in deceased donor liver transplantation (LT) have been rarely studied. The aim of this study was to determine whether a large-sized graft for recipient influenced the post-transplant outcomes. METHODS:A total of 273 patients undergoing LT were enrolled and divided ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.16132

    authors: Shen Z,Wang Z,Jiang Y,Wu T,Zheng S

    更新日期:2020-07-01 00:00:00

  • Regional versus metropolitan pancreaticoduodenectomy mortality in Australia.

    abstract:BACKGROUND:This retrospective, population-based cohort study aims to determine if differences in the regional distribution of procedures or variation in regional mortality contributes to the variable pancreaticoduodenectomy (PD) mortality between Australian states and territories. METHODS:De-identified procedural data...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15336

    authors: Davis SS,Babidge WJ,Kiermeier A,Maddern GJ

    更新日期:2019-12-01 00:00:00

  • Surgical management of breast cancer in a small peripheral New Zealand hospital.

    abstract:BACKGROUND:Peripheral hospitals are perceived to be at a disadvantage in providing treatment for breast cancer, especially with regard to breast conservative surgery (BCS) because of the requirement of adjuvant radiotherapy. Wairau Hospital is a 100-bed peripheral hospital in New Zealand with no on-site radiotherapy un...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2006.03940.x

    authors: Lee DW,Vallance S

    更新日期:2006-12-01 00:00:00

  • Changing pattern of adrenalectomy at a tertiary referral centre 1970-2000.

    abstract:BACKGROUND:In 1987, a report from this unit described the changing indications for open adrenalectomy over a 15-year period. The indications for adrenalectomy had switched from it being the principal therapeutic procedure used in advanced breast cancer in the early 1970s, to being predominately performed for Cushing's ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1445-2197.2002.02454.x

    authors: Sidhu S,Bambach C,Pillinger S,Reeve T,Stokes G,Robinson B,Delbridge L

    更新日期:2002-07-01 00:00:00

  • How to do it: value-driven sharp recanalization of central vein occlusion.

    abstract::Patients on haemodialysis are susceptible for central vein occlusions, which can result in debilitating clinical consequences. These may be resistant to conventional revascularization with guidewire and catheter technique. Value-driven sharp recanalization of central vein occlusion is depicted as a safe and affordable...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15599

    authors: Yoong GSW,Koh FHX,Wee BBK,Anil G,Ho P

    更新日期:2020-03-01 00:00:00

  • Many faces of pancreaticobiliary reflux.

    abstract::Pancreaticobiliary reflux may occur either as a result of an anatomically abnormal pancreaticobiliary junction or because of a functionally impaired sphincter despite a normal radiological appearance. It is associated with a wide spectrum of biliary diseases, including gall bladder and bile duct carcinoma. Pancreatico...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1111/j.1445-2197.2012.06076.x

    authors: Williams NE,Gundara JS,Hugh TJ,Samra JS

    更新日期:2012-06-01 00:00:00

  • Laparoscopic-assisted colectomy with Duhamel procedure for idiopathic megacolon in adults: a retrospective study.

    abstract:BACKGROUND:Idiopathic megacolon (IMC) is an uncommon disease in adults. To date, only a few laparoscopic experiences and functional outcomes of IMC have been reported. This study was to retrospectively analyse our 12 year surgical experience and functional outcomes in adult patients with IMC. METHODS:A 12-year retrosp...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15868

    authors: Wang L,Zheng H,Tian Y,Mou J,Zhang L,Liu B,Tong W

    更新日期:2020-11-01 00:00:00

  • Prolonged surgical duration, higher body mass index and current smoking increases risk of surgical site infection after intra-articular fracture of distal femur.

    abstract:BACKGROUND:This study aimed to investigate incidence of surgical site infection (SSI) following the surgery of intra-articular fractures of distal femur. METHODS:Between July 2014 and December 2017, inpatient medical records of consecutive patients who had intra-articular fractures of distal femur treated by open redu...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15263

    authors: Xu H,Yu L,Li Y,Gong Z

    更新日期:2019-06-01 00:00:00

  • Morgagni's hernia: believing is seeing.

    abstract::The original description by Morgagni of the anterior diaphragmatic defect that bears his name implies a paramedian defect and this may be true when acquired in adulthood. In contrast, the anterior diaphragmatic defect that is observed in children is central rather than paramedian, as is often assumed. Its central retr...

    journal_title:ANZ journal of surgery

    pub_type: 传,历史文章,杂志文章

    doi:10.1111/j.1445-2197.2008.04641.x

    authors: McBride CA,Beasley SW

    更新日期:2008-09-01 00:00:00

  • The Surgical Research Society of Australasia.

    abstract:BACKGROUND:The Surgical Research Society of Australasia (SRS) was established in 1961. The main intent was to promote surgical research, especially by young surgeons. The 50th Scientific Meeting of the SRS is due to be held in 2002. METHODS:Selected information was extracted from the programme books for the scientific...

    journal_title:ANZ journal of surgery

    pub_type: 历史文章,杂志文章

    doi:10.1046/j.1445-2197.2002.02533.x

    authors: Hall JC,Ludbrook J

    更新日期:2002-10-01 00:00:00

  • Survey of trends in minimally invasive intervention for necrotizing pancreatitis.

    abstract:BACKGROUND:Minimally invasive techniques to manage infected pancreatic necrosis have been recently developed and changes in their pattern of use are unknown. The aims of this survey were to determine the trends in the role of minimally invasive techniques to manage infected complications of necrotizing pancreatitis and...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2010.05265.x

    authors: Loveday BP,Rossaak JI,Mittal A,Phillips A,Windsor JA

    更新日期:2011-01-01 00:00:00

  • Predicting occult malignancy in nipple discharge.

    abstract:BACKGROUND:This study was a retrospective analysis of patients who underwent minor or major duct surgery for pathological nipple discharge. The results of clinical examination, mammography, ultrasonography and cytodiagnosis of the nipple discharge were studied in order to predict those patients at risk of underlying or...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2010.05270.x

    authors: Alcock C,Layer GT

    更新日期:2010-09-01 00:00:00

  • Trainee surgeons and patient outcomes in carotid endarterectomy: a retrospective cohort study.

    abstract:BACKGROUND:In Australia and New Zealand, more than 2000 carotid endarterectomies are performed annually. The major morbidities arising from this procedure are post-operative stroke, cranial nerve injury and death. Carotid endarterectomy surgery is a key component of the vascular surgical training programme. We assessed...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.16209

    authors: Johnson NW,Smoll NR,Tan C,Brooks CE

    更新日期:2020-09-01 00:00:00

  • Unequal access to breast-conserving surgery in Western Australia 1982-2000.

    abstract:BACKGROUND:The purpose of the present study was to examine the effects of demographic, locational and social disadvantage and the possession of private health insurance in Western Australia on the likelihood of women with breast cancer receiving breast-conserving surgery rather than mastectomy. METHODS:The WA Record L...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-1433.2004.03020.x

    authors: Hall SE,Holman CD,Hendrie DV,Spilsbury K

    更新日期:2004-06-01 00:00:00

  • Effects of trapidil on the healing of colonic anastomoses in an experimental rat model.

    abstract:BACKGROUND:Trapidil has various properties including vasodilatation, inhibition of lipid peroxidation and platelet aggregation as well as, and reduction of, the inflammatory response to injury. The aim of the present study was to investigate the effects of trapidil on dexamethasone-impaired colonic anastomotic healing ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1445-2197.2003.02683.x

    authors: Colak T,Nayci A,Polat G,Polat A,Comelekoglu U,Kanik A,Turkmenoglu O,Aydin S

    更新日期:2003-11-01 00:00:00

  • Residual cancerous lesion and vein tumour thrombus identified intraoperatively using a fluorescence navigation system in liver surgery.

    abstract:AIM:The main aims of this study are to investigate the clinical application value of using indocyanine green fluorescence imaging for ensuring complete resection of tumour tissue during hepatectomy and to evaluate the diagnostic efficacy of near-infrared (NIR) fluorescence imaging system using indocyanine green in hepa...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15282

    authors: He P,Su S,Fang C,He K,Chi C,Xia X,Tian J,Li B

    更新日期:2019-07-01 00:00:00

  • Effect of exercise prehabilitation on functional status of patients undergoing bowel resection: a systematic review.

    abstract:BACKGROUND:Bowel resections have high morbidity and mortality rates and are becoming increasingly common in Australia. To reduce the burden on patients and the health system, measures for improving patient outcomes after resection must be investigated. One possible method for improving patient outcomes is prehabilitati...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1111/ans.15659

    authors: Teo JYK,Turner R,Self M

    更新日期:2020-05-01 00:00:00

  • Unusual case of Morgagni hernia associated with malrotation.

    abstract::Morgagni herniae are rare congenital diaphragmatic hernia, which normally present late in adult life with minimal symptoms. They are always associated with a peritoneal hernial sac, and often contain transverse colon or stomach. We present an unusual case of a Morgagni hernia containing caecum in an 81-year-old woman,...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1445-2197.2003.02745.x

    authors: Court FG,Wemyss-Holden SA,Fitridge R,Maddern GJ

    更新日期:2003-09-01 00:00:00

  • Developmental anomaly of the inferior vena cava.

    abstract::Despite the many possible modes of presentation, congenital anomalies of the inferior vena cava are increasingly being found in asymptomatic patients. Although plain chest radiography may reveal enough suggestive signs, the diagnosis is usually confirmed by ultrasound, computed tomography and magnetic resonance imagin...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1445-2197.2003.02502.x

    authors: Sandercoe GD,Brooke-Cowden GL

    更新日期:2003-05-01 00:00:00

  • Endovascular grafting of the thoracic aorta, an evolving therapy: ten-year experience in a single centre.

    abstract:BACKGROUND:Surgical therapy for the thoracic aorta carries a high morbidity and mortality. Endovascular therapy for aneurysms and its adaptation to the thoracic aorta over the past 10 years is an exciting advance. This is a retrospective review of endovascular grafting of the thoracic aorta during the past decade at Ro...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2007.04293.x

    authors: Sandroussi C,Waltham M,Hughes CF,May J,Harris JP,Stephen MS,White GH

    更新日期:2007-11-01 00:00:00

  • Review of knee arthroscopic practice and coding at a major metropolitan centre.

    abstract:BACKGROUND:Arthroscopic knee surgery has been a topic of significant controversy in recent orthopaedic literature. Multiple studies have used administrative (Victorian Admitted Episodes Dataset and Centre for Health Record Linkage) data to identify trends in practice. This study explored the usage and reporting of arth...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1111/ans.13664

    authors: Lisik JP,Dowsey MM,Petterwood J,Choong PFM

    更新日期:2017-05-01 00:00:00

  • Comparative analysis of emergency general surgery on-call structure and its impact on emergency appendicectomy outcomes.

    abstract:BACKGROUND:In Australia, there has been a shift from the traditional 'on-call' surgical model to the 'acute surgical unit' (ASU) model to improve outcomes in acute general surgery. Using emergency appendicectomy as a standardized procedure, we aimed to identify the different patterns of care between these on-call struc...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.16558

    authors: Gounder J,Dissanayake B,Burstow MJ,Yuide PJ,Naidu S,Lancashire RP,Chua TC

    更新日期:2021-01-18 00:00:00

  • Total knee replacement in the morbidly obese: a literature review.

    abstract:BACKGROUND:The 'obesity epidemic' is expected to result in an increased incidence of knee osteoarthritis and hence total knee replacements (TKRs). Reviews have demonstrated the conflicting results of TKR for all obese (body mass index (BMI) >30). The aim of this literature review was to specifically evaluate outcomes o...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1111/j.1445-2197.2010.05396.x

    authors: Samson AJ,Mercer GE,Campbell DG

    更新日期:2010-09-01 00:00:00

  • Solid pseudopapillary tumour of the pancreas.

    abstract:BACKGROUND:Solid pseudopapillary tumour of the pancreas is a rare pancreatic tumour that occurs predominantly in women, with very few cases reported in men. This is a tumour with low malignancy potential and surgical resection usually results in cure. METHODS:A retrospective review of our experience with solid pseudop...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1445-2197.2003.t01-1-02634.x

    authors: Ng KH,Tan PH,Thng CH,Ooi LL

    更新日期:2003-06-01 00:00:00

  • Haemorrhagic complications of pancreaticoduodenectomy.

    abstract:BACKGROUND:Haemorrhagic complication occurs in 5-16% of patients following pancreaticoduodenectomy (PD). We report an analysis of patients with post-PD bleed, to identify predictors of bleed, predictors of survival following bleed and the management of post-PD bleed. METHODS:Two hundred and eighteen patients with peri...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-1433.2004.03212.x

    authors: Balachandran P,Sikora SS,Raghavendra Rao RV,Kumar A,Saxena R,Kapoor VK

    更新日期:2004-11-01 00:00:00

  • Ethnic disparities in rates of publicly funded bariatric surgery in New Zealand (2009-2014).

    abstract:BACKGROUND:Publicly funded bariatric surgery in New Zealand (NZ) is steadily on the rise to meet the obesity epidemic. Ethnic disparities in obesity rates exist in NZ with Māori and Pacific people having three to five times higher rates than all other ethnic groups within NZ. Ethnic disparities in rates of bariatric su...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.14220

    authors: Rahiri JL,Lauti M,Harwood M,MacCormick AD,Hill AG

    更新日期:2018-05-01 00:00:00

  • Laparoscopic radical prostatectomy: early safety and efficacy.

    abstract:BACKGROUND:To evaluate the initial results of laparoscopic radical prostatectomy at this institution. METHODS:Between January 2000 and September 2003, 30 patients underwent laparoscopic radical prostatectomy. Peri- and postoperative data were accumulated prospectively and maintained in a database. All patients have a ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-1433.2004.03269.x

    authors: Wilson LC,Kennett KM,Gilling PJ

    更新日期:2004-12-01 00:00:00