Timing to First Whole Blood Transfusion and Survival Following Severe Hemorrhage in Trauma Patients
An erratum to this article was published (JAMA Surg, 1 Apr 2024 ↗)
Authors' conclusion
In this cohort study, receipt of a WB transfusion earlier at any time point within the first 24 hours of ED arrival was associated with improved survival in patients presenting with severe hemorrhage.
Study context
- Population
- Adult trauma patients at US and Canadian level 1 and 2 trauma centers with SBP <90 mm Hg, shock index >1, requiring massive transfusion protocol (MTP) and receiving whole-blood (WB) within 24 h of emergency department (ED) arrival, 2019–2020; burns, prehospital cardiac arrest, deaths within 1 h and interfacility transfers excluded
- Participants
- 1,394 patients
- Exposure
- Earlier vs Later
- Outcome
- Survival
- Follow-up
- 24 hours and 30 days
Methodological detailsregistry-based (ACS TQIP databank), multicentre, Data analyzed from January 3 to October 2, 2023
- Registry-based (ACS TQIP databank)
- Multicentre
- Data analyzed from January 3 to October 2, 2023
Main finding
As reported in the abstract
Survival at 24 hours and 30 days
Earlier vs LaterAHR for death (95% CI)P value
24 hours; improved survival
0.40(0.22–0.73)
P = 0.00330 days; improved survival
0.32(0.22–0.45)
P < 0.001Observational data: associations, not effects.
Further findings
Survival curve
- Difference in survival within 1 hour of ED presentation and WB transfusion
Original publication
Timing to First Whole Blood Transfusion and Survival Following Severe Hemorrhage in Trauma Patients. JAMA Surg. Published 1 April 2024. doi:10.
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