Whole Blood and Blood Component Resuscitation in Trauma: Interaction and Association With Mortality
Main finding · 4-hour mortalityResult — go to the resultAdjusted odds ratio 0.81 CI 0.68–0.97Authors' conclusion
WB resuscitation, higher WB:TTV ratios, and balanced blood component transfusion in conjunction with WB were associated with lower mortality in patients with trauma presenting in shock requiring at least 4 units of red blood cells and/or WB transfusion within 4 hours of arrival.
Study context
- Population
- Adult trauma patients with shock index >1 receiving ≥4 combined units of RBC and/or whole blood (WB) within 4 hours, 501 US trauma centers (ACS TQIP database)
- Participants
- 12,275 patients · 501 US trauma centers
- Exposure
- Whole blood resuscitation vs component-only resuscitation
- WBn = 2,884
- Component-onlyn = 9,391reference
- Outcome
- Mortality
- Follow-up
- 4-hour, 24-hour and 30-day
Methodological detailsmulticentre registry, multivariable analysis
- Multicentre registry
- Multivariable analysis
Main finding
4-hour mortality · 4 hours
Adjusted odds ratio
0.81
CI 0.68–0.97
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| WB:TTV ratio and 4-hour mortality (per 10% increase) · 13% decrease in odds of 4-hour mortality | 0.87 (0.80–0.94) | |
| 0.512Odds ratio (log scale) |
Balanced blood component transfusion with combined WB and component resuscitation: 4-hour mortality
| aOR (95% CI) | ||
|---|---|---|
| Balanced blood component transfusion | 0.45 (0.29–0.68) | |
| 0.20.5125Adjusted odds ratio (log scale) |
WB:TTV ratio and 4-hour mortality (per 10% increase)
- Higher WB:TTV ratios significantly associated with lower 4-hour, 24-hour and 30-day mortality
Balanced blood component transfusion with combined WB and component resuscitation: 4-hour mortality
- Also significantly lower odds of 24-hour and 30-day mortality
Original publication
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