What is the Difference Between Predicted Need for Massive Transfusion and Actual Transfusion in Adult Trauma Patients in an Urban Indian Setting?

Background

Trauma fatalities account for 9 % of the world's deaths, superseding the number of deaths caused by HIV/AIDS, tuberculosis and malaria combined, disproportionately affecting low- and middle-income countries (LMIC). Hemorrhage is one of the leading causes of preventable death among trauma patients. Up to 5 % of trauma patients require massive transfusions (MT), defined as administration of ten or more units of packed red blood cells (PRBC) within 24 hours of injury.

India is an LMIC lacking structured trauma care systems and where blood products remain a scarce commodity. There is a sizeable gap in supply and demand as India lacks about four million units of blood per year according to World Health Organization estimates. The in-hospital mortality in an urban Indian trauma setting has been found to be twice that of high-income equivalents and inadequate resuscitation and bleeding control of hemorrhaging patients has been found to be the main cause of preventable deaths.

Considering the general lack of blood components in India it is reasonable to assume that there is an unmet need of blood transfusions in trauma patients as well. The extent of the potentially unmet need of MT constitutes a major gap of knowledge and also an important basis for resource allocation and development of MT protocols suited for local needs, hence our research question: what is the difference between predicted need for MT and actual transfusion in an urban Indian trauma setting?

Aim