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We also evaluated whether massive transfusion was related to increased morbidity and mortality.
Massive transfusion was required for 49 patients (6.1%) and 89 patients (11.0%) had ATC.
However, massive transfusion was not found to be an independent factor for predicting the SOFA scores in the multivariable analysis.
Massive transfusion was defined at ≥10 units of packed red blood cells in a 24 hour period.
At a sensitivity of 90%, specificity for massive transfusion was only 50%, with 58% of patients correctly classified.
A logistic model for prediction of massive transfusion was developed and validated at multiple sites but achieved only moderate performance.
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In conclusion, perioperative bleeding and massive transfusion were associated with increased morbidity and mortality in this group of patients, which may prompt a review of surgical procedures and the introduction of new techniques, such as thromboelastography.
Bleeding in Cardiac Surgery: Should Massive Transfusion Be in a 1 1 1 Ratio?
Prospective trials investigating the optimal plasma to RBC ratio in patients requiring massive transfusion are warranted.
In summary, current definitions of massive transfusion are not supported by clinical outcomes and are not useful for guiding management.
Due to the citrate load associated with transfusion, patients having received a massive transfusion are also at risk of citrate accumulation.
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