Clinical Research Directory

Inclusion Criteria: Adult trauma patients (≥18 years) presenting directly to the trauma center were eligible for inclusion if they met at least one of the following criteria: 1. Injury Severity Score (ISS) ≥16, or 2. requirement for massive transfusion, defined as \>10 units of packed red blood cells (PRBC) within the first 24 hours. Exclusion Criteria: * Death on arrival, * Transfer from external institutions after initial resuscitation * Incomplete transfusion or outcome data * Significant pre-existing comorbidities (including advanced heart failure, end-stage renal disease, cirrhosis with portal hypertension, chronic oxygen dependence, or non-reversible anticoagulation therapy). * Patients with isolated minor injuries not requiring trauma team activation were also excluded.