The Association of Blood Component Use Ratios With the Survival of Massively Transfused Trauma Patients With and Without Severe Brain Injury
Abstract
Background: The effect of blood component ratios on the survival of patients with traumatic brain injury (TBI) has not been studied. Methods: A database of patients transfused in the first 24 hours after admission for injury from 22 Level I trauma centers over an 18-month period was queried to find patients who (1) met different definitions of massive transfusion (5 units red blood cell [RBC] in 6 hours vs. 10 units RBC in 24 hours), (2) received high or low ratios of platelets or plasma to RBC units (<1:2 vs. >/=1:2), and (3) had severe TBI (head abbreviated injury score >/=3) (TBI+). Results: Of 2,312 total patients, 850 patients were transfused with >/= 5 RBC units in 6 hours and 807 could be classified into TBi+ (n = 281) or TBI- (n = 526). Six hundred forty-three patients were transfused with >/=10 RBC units in 24 hours with 622 classified into TBI+ (n = 220) and TBi- (n = 402). For both high-risk populations, a high ratio of platelets:RBCs (not plasma) was independently associated with improved 30-day survival for patients with TBI+ and a high ratio of plasma:RBCs (not platelets) was independently associated with improved 30-day survival in TBI- patients. Conclusions: High platelet ratio was associated with improved survival in TBI+ patients while a high plasma ratio was associated with improved survival in TBI- patients. Prospective studies of blood product ratios should include TBI in the analysis for determination of optimal use of ratios on outcome in injured patients.
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 01, 2011
- Accession Number
- ADA618808
Entities
People
- Charles E Wade
- Fei Du
- Jeremy G. Perkins
- John R Hess
- Lee A. Zarzabal
- Lorne H Blackbourne
- Marc Maegele
- Martin Schreiber
- Matthew A. Borgman
- Philip C Spinella
Organizations
- United States Army Institute of Surgical Research