Background The practice of massive transfusion in clinical settings, while essential, faces challenges due to undefined protocols and high mortality rates.
Objective To explore the prevalence and outcomes of massive transfusion, focusing on identifying primary clinical indications and the impact of transfusion ratios on patient survival.
Methods A multicenter retrospective study (MATRA-A) involving six University and Training Research Hospitals in Ankara, analyzing patients over 18 who received massive transfusions (≥10 units/24 h) between 2017 and 2019.
Participants A total of 167 patients who underwent massive transfusions, constituting 0.27% of all transfused patients during the study period.
Main Measures The study measured the volume of red blood cells (RBCs), fresh frozen plasma (FFP), and platelets transfused, the clinical conditions necessitating massive transfusion, and the associated mortality rates, especially focusing on the FFP:RBC:Platelets ratio.
Results The majority of massive transfusions were administered to surgical patients, with cardiovascular diseases, trauma, and malignancies being the top indications. The analysis revealed a significant correlation between higher survival rates in trauma patients and a high FFP:RBCs ratio. Overall, massive transfusion was rare but associated with a high mortality rate.
Conclusions Cardiovascular events and trauma are the leading causes for massive transfusions, which are linked with significant mortality. The study highlights the potential benefit of optimizing FFP:RBC ratios in improving outcomes for massively transfused trauma patients, suggesting the need for further focused research to refine national protocols.