Objective To explore the relationship between red blood cell transfusion volume and patients' mortality in mas-sive blood transfusion. Methods Multicenter retrospective research was carried out on 1601 surgical inpatients who receiving massive blood transfusion in 20 large comprehensive hospitals in China. According to red blood cell transfusion volume within 24 hours or 72 hours, they are divided into 8 groups: 0-4U, 5-9U, 10-14U, 15-19U, 20-24U, 25-29U, 30-39U, 40U-. The status of patients' death with different red blood cell transfusion volume was analyzed. Results Patients' mortality increases with the in-crease of red blood cell transfusion when total red blood cell transfusion volume ≥10U within 24 or 72 hours. Survival analysis based on different red blood cell transfusion volume was of statistical significance (χ2=72.857, P<0.001). Logistic regression analy-sis reveals that red blood cell transfusion volume was an independent risk factor (OR=0.52;CI:0.43-0.64; P<0.01) for death of pa-tients in massive blood transfusion. When red blood cells were transfused at 5U-9U volume within 24 and 72 hours, mortality is the lowest, which was 3.7% and 2.3% respectively. Conclusions During massive blood transfusion for surgical inpatients, there is some correlation between red blood cell transfusion volume within 24 or 72 hours and mortality of patients. Patients' mortality in-creases with the increase of red blood cell transfusion. Red blood cell transfusion volume, length of stay at hospital and intensive care unit constitute the independent risk factors for patients' death.%目的：联合国内20家大型综合医院多中心回顾性调研外科住院患者大量输血病历1601例，分析探讨红细胞输注量与患者死亡率的关联性。方法联合全国20家三级综合医院进行多中心回顾性分析大量输血病例资料，根据24h内或72h内红细胞输注量分为：0~4U、5~9U、10~14U、15~19U、20~24U、25~29U、30~39U、40~U，8个组段，对红细胞输注不同量患者死亡情况进行分析，研究红细胞输注量与患者死亡率的关系。结果24h或72h内，红细胞输注总量≥10U后，患者死亡率随红细胞用量而增加，24h内红细胞应用10U~40U，死亡率为6.0%~38.9%；72h内红细胞应用10U~40U，死亡率为5.2%~28.0%；24h和72h红细胞在应用5U~9U组段者死亡率最低，分别是3.7%和2.3%；在0~4U组段，死亡率分别为7.3%和9.7%。结论外科住院患者大量输血时，24h或72h内红细胞输注量与死亡率有一定的关联性，患者死亡率随红细胞输注量增多而升高。
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