ArticleCritical care medicine2016
Epidemiology of Massive Transfusion: A Binational Study From Sweden and Denmark.
Article in Critical care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Definitions of massive transfusion in adults with critical bleeding: a systematic review.Critical care (London, England) · 2023Pooled it
- The Australian and New Zealand Massive Transfusion Registry: An innovation focusing on data collection, standardisation and interoperability between healthcare systems.Health information management : journal of the Health Information Management Association of Australia · 2026Article
- Pre-hospital blood transfusion in non-traumatic major haemorrhage: a retrospective observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Observational
- Electronic health records reveal variations in the use of blood units by hour and medical specialty.Vox sanguinis · 2025Article
- Hemorrhagic Shock and Mitochondria: Pathophysiology and Therapeutic Approaches.International journal of molecular sciences · 2025Review
- Major Bleeding in the Emergency Department: A Practical Guide for Optimal Management.Journal of clinical medicine · 2025Review
- Effects of erythropoietin administration on allogeneic blood transfusion requirements in adults undergoing surgery: a systematic review and meta-analysis.Frontiers in medicine · 2025Review
- Clinical management of active bleeding: what the emergency radiologist needs to know.Emergency radiology · 2024Review
- Protective effect of 8-Gingerol, a potent constituent of ginger, on acute lung injury following hemorrhagic shock in rats.Experimental animals · 2024Article
- Evaluation of hemorrhagic shock and fluid resuscitation in pigs using handless Doppler carotid artery ultrasound.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- The regulatory effects of serum catecholamines and endothelial cells in pig hemorrhagic shock and fluid resuscitation models.Resuscitation plus · 2024Article
- Contemporary management of major haemorrhage in critical care.Intensive care medicine · 2024Review
- Transfusion practice in Central Norway - a regional cohort study in patients suffering from major haemorrhage.BMC emergency medicine · 2024Observational
- Sex Dimorphism in Outcome of Trauma Patients Presenting with Severe Shock: A Multicenter Cohort Study.Journal of clinical medicine · 2023Article
- Major haemorrhage: past, present and future.Anaesthesia · 2023Review
- Clinical Implication of the Acumen Hypotension Prediction Index for Reducing Intraoperative Haemorrhage in Patients Undergoing Lumbar Spinal Fusion Surgery: A Prospective Randomised Controlled Single-Blinded Trial.Journal of clinical medicine · 2022Article
- Observational
- Innate immunity and immunotherapy for hemorrhagic shock.Frontiers in immunology · 2022Review
- Mitochondrial antioxidant SkQ1 decreases inflammation following hemorrhagic shock by protecting myocardial mitochondria.Frontiers in physiology · 2022Article
- Tyrosine kinase nonreceptor 1 (TNK1) knockdown ameliorates hemorrhage shock-induced kidney injury via inhibiting macrophage M1 polarization.3 Biotech · 2021Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThere is an increasing focus on massive transfusion, but there is a paucity of comprehensive descriptions of the massively transfused patients and their outcomes. The objective of this study is to describe the incidence rate of massive transfusion, patient characteristics, and the mortality of massively transfused patients.
designDescriptive cohort study.
settingNationwide study with data from Sweden and Denmark. PATIENTS: The study was based on the Scandinavian Donations and Transfusions database, including all patients receiving 10 or more red cell concentrate transfusions in Sweden from 1987 and in Denmark from 1996. A total of 92,057 patients were included. Patients were followed until the end of 2012. MEASUREMENTS AND MAIN
resultsDescriptive statistics were used to characterize the patients and indications. Post transfusion mortality was expressed as crude 30-day mortality and as long-term mortality using the Kaplan-Meier method and using standardized mortality ratios. The incidence of massive transfusion was higher in Denmark (4.5 per 10,000) than in Sweden (2.5 per 10,000). The most common indication for massive transfusion was major surgery (61.2%) followed by trauma (15.4%). Massive transfusion due to obstetrical bleeding constituted only 1.8%. The overall 5-year mortality was very high (54.6%), however with large differences between indication groups, ranging from 91.1% among those transfused for a malignant disease without surgery to 1.7% among patients transfused for obstetrical bleeding. The early standardized mortality ratios were high and decreased thereafter, but remained elevated throughout the time period.
conclusionsThis large-scale study based on nationwide data from Sweden and Denmark describes the complete range of massive transfusion. We report a nonnegligible incidence and both a high absolute mortality and high standardized mortality ratio. The general pattern was similar for Sweden and Denmark, and we believe that similar patterns may be found in other high-resource countries. The study provides a relevant background for clinicians and researchers for designing future studies in this field.
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