{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:06:34Z","timestamp":1747188394952,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["T32GM121290"],"award-info":[{"award-number":["T32GM121290"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Large trauma centers have protocols for the assessment of injury and triaging of care with attempts to over\u2010triage to ensure adequate care for all patients. We noted that a significant number of patients undergo a second massive transfusion protocol (MTP) activation in the first 24\u2009h of care and conducted a retrospective cohort study of patients involved over a 3\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Transfusion service records of MTP activations 2019\u20132021 were linked to Trauma Registry records and divided into cohorts receiving a single versus a reactivation of the MTP. Time of activation and amounts of blood products issued were linked to demographic, injury severity, and outcome data. Categorical and continuous data were compared between cohorts with chi\u2010squared, Fisher's, and Wilcoxan tests as appropriate, and multivariable regression models were used to seek interactions (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>MTP activation was recorded for 1884 acute trauma patients over our 3\u2010year study period, 142 of whom (7.5%) had reactivation. Factors associated with reactivation included older age (46 vs. 40\u2009years), higher injury severity score (ISS, 27 vs. 22), leg injuries, and presentation during morning shift change (5\u20137\u2009a.m., 3.3% vs. 7.7%). Patients undergoing MTP reactivation used more RBCs (5\u2009U vs. 2\u2009U) and had more ICU days (3 vs. 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Older patients and those presenting during shift change are at risk for failure to recognize their complex injury patterns and under\u2010triage for trauma care. The fidelity and granularity of transfusion service records can provide unique opportunities for quality assessment and improvement in trauma care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17719","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T09:00:34Z","timestamp":1706000434000},"page":"248-254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Massive transfusion protocol reactivation as a novel marker of physician team under\u2010triage after injury"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6985-2573","authenticated-orcid":false,"given":"Michael B.","family":"Weykamp","sequence":"first","affiliation":[{"name":"Department of Surgery, Harborview Medical Center University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhinan","family":"Liu","sequence":"additional","affiliation":[{"name":"Transfusion Service Harborview Medical Center  Seattle Washington USA"},{"name":"Harborview Injury Prevention and Research Center Harborview Medical Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren R.","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Transfusion Service Harborview Medical Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Tuott","sequence":"additional","affiliation":[{"name":"Harborview Injury Prevention and Research Center Harborview Medical Center  Seattle Washington USA"},{"name":"Department of Laboratory Medicine and Pathology University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryce R. H.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Harborview Medical Center University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica S.","family":"Vavilala","sequence":"additional","affiliation":[{"name":"Harborview Injury Prevention and Research Center Harborview Medical Center  Seattle Washington USA"},{"name":"Department of Anesthesiology and Pain Medicine University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6832-881X","authenticated-orcid":false,"given":"Lynn G.","family":"Stansbury","sequence":"additional","affiliation":[{"name":"Harborview Injury Prevention and Research Center Harborview Medical Center  Seattle Washington USA"},{"name":"Department of Laboratory Medicine and Pathology University of Washington  Seattle Washington USA"},{"name":"Department of Anesthesiology and Pain Medicine University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8596-4420","authenticated-orcid":false,"given":"John R.","family":"Hess","sequence":"additional","affiliation":[{"name":"Transfusion Service Harborview Medical Center  Seattle Washington USA"},{"name":"Harborview Injury Prevention and Research Center Harborview Medical Center  Seattle Washington USA"},{"name":"Department of Laboratory Medicine and Pathology University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003627"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2010.08.014"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002602"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001560"},{"issue":"5","key":"e_1_2_10_6_1","first-page":"1298","article-title":"The trade\u2010offs in field trauma triage: a multiregion assessment of accuracy metrics and volume shifts associated with different triage strategies","volume":"74","author":"Newgard CD","year":"2013","journal-title":"J Trauma Acute Care 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