title: Evaluation of recombinant factor VIIa treatment for massive hemorrhage in patients with multiple traumas.
abstract: BACKGROUND
  Recent studies and case reports have shown that recombinant factor VIIa (rFVIIa) treatment is effective for reversing coagulopathy and reducing blood transfusion requirements in trauma patients with life-threatening hemorrhage. The purpose of this study is to evaluate the effect of rFVIIa treatment on clinical outcomes and cost effectiveness in trauma patients.
  
  
  METHODS
  Between January 2007 and December 2010, we reviewed the medical records of patients who were treated with rFVIIa (N=18) or without rFVIIa (N=36) for life-threatening hemorrhage due to multiple traumas at the Emergency Department of Pusan National University Hospital in Busan, Korea. We reviewed patient demographics, baseline characteristics, initial vital signs, laboratory test results, and number of units transfused, and then analyzed clinical outcomes and 24-hr and 30-day mortality rates. Thromboembolic events were monitored in all patients. Transfusion costs and hospital stay costs were also calculated.
  
  
  RESULTS
  In the rFVIIa-treated group, laboratory test results and clinical outcomes improved, and the 24-hr mortality rate decreased compared to that in the untreated group; however, 30-day mortality rate did not differ between the groups. Thromboembolic events did not occur in both groups. Transfusion and hospital stay costs in the rFVIIa-treated group were cost effective; however, total treatment costs, including the cost of rFVIIa, were not cost effective.
  
  
  CONCLUSIONS
  In our study, rFVIIa treatment was shown to be helpful as a supplementary drug to improve clinical outcomes and reduce the 24-hr mortality rate, transfusion and hospital stay costs, and transfusion requirements in trauma patients with life-threatening hemorrhage.
authors.affiliation: Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Young Rae
authors.initials: YR
authors.lastname: Koh
authors.forename: Suck Ju
authors.initials: SJ
authors.lastname: Cho
authors.forename: Seok Ran
authors.initials: SR
authors.lastname: Yeom
authors.forename: Chulhun L
authors.initials: CL
authors.lastname: Chang
authors.forename: Eun Yup
authors.initials: EY
authors.lastname: Lee
authors.forename: Han Chul
authors.initials: HC
authors.lastname: Son
authors.forename: Hyung Hoi
authors.initials: HH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015942:Factor VIIa / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis; D006470:Hemorrhage / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications*; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011517:Prothrombin Time; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins; D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa