[Recombinant factor VIIa for the treatment of exsanguinating trauma patients: a matched-pair analysis from the Trauma Registry of the German Society for Trauma Surgery].
BACKGROUND
The aim of the study was to assess whether the use of recombinant factor VIIa (rFVIIa) in trauma patients was associated with improved outcome.


METHODS
Patients documented in the TraumaRegistry of the German Society for Trauma Surgery (primary admissions; Injury Severity Score, ISS ≥ 9) who received rFVIIa in the first 6 hours upon admission (rFVIIa +) were matched with patients that had not received rFVIIa (rFVIIa-).


RESULTS
The matching comparison yielded two identical groups with 100 patients each (rFVIIa+: average age 40.6 ± 18.5 years, ISS 47.1 ± 16.7 versus rFVIIa-: 40.1 ± 19.1 years, ISS 45.1 ± 15.6). Patients were administered an average of 18.3 ± 13.1 (rFVIIa+) versus 19.5 ± 14.0 (rFVIIa-) red blood cell units (p = 0.55) and 15.2 ± 13.7 (rFVIIa+) versus 15.0 ± 13.1 (rFVIIa-) units of fresh frozen plasma (p = 0.92). Thromboembolisms occurred in 5% (rFVIIa+) versus 2% (rFVIIa-) (p = 0.44), multiple organ failure (MOF) in 82% versus 62% (p = 0.003) and hospital mortality was 48% versus 43% (p = 0.57), respectively.


CONCLUSIONS
The early use of rFVIIa in severely injured patients was not associated with either lower transfusion requirements or with mortality reduction but with increased MOF.
Lehrstuhl für Unfallchirurgie, Orthopädie und Sporttraumatologie, Universitätsklinik Witten/Herdecke am Klinikum Köln-Merheim, Ostmerheimerstrasse 200, 51109, Köln, Deutschland. wafaisadea@kliniken-koeln.de
A
A
Wafaisade
R
R
Lefering
M
M
Maegele
P
P
Helm
M
M
Braun
T
T
Paffrath
B
B
Bouillon
D000328:Adult; D001803:Blood Transfusion / Q000401:mortality*; D015897:Comorbidity; D058734:Exsanguination / Q000401:mortality* / Q000517:prevention & control*; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D015995:Prevalence; D011994:Recombinant Proteins / Q000627:therapeutic use; D012042:Registries; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000401:mortality* / Q000628:therapy*
D006490:Hemostatics; D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa