• Tim W H Rijnhout, Femke Noorman, TanEdward C T HECTHDepartment of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands. Electronic address: edward.tan@radboudumc.nl., Victor V A Viersen, van der BurgB L S BorgerBLSBDepartment of Surgery, Alrijne Medical Centre, 2353 GA Leiderdorp, the Netherlands. Electronic address: blsborgervanderburg@alrijne.nl., Michaëla van Bohemen, WaesOscar J F vanOJFVTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, 3000 CA Rotterdam, the Netherlands. Electronic address: o.vanwaes@erasmusmc.nl., VerhofstadMichael H JMHJTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, 3000 CA Rotterdam, the Netherlands. Electronic address: m.verhofstad@erasmusmc.nl., and Rigo Hoencamp.
• Department of Surgery, Alrijne Medical Centre, 2353 GA Leiderdorp, the Netherlands; Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands. Electronic address: t.rijnhout@erasmusmc.nl.
• Injury. 2024 Nov 12: 112021112021.

BackgroundThe optimal transfusion ratio of platelets (PLT), plasma and red blood cells (RBC) in trauma patients with massive haemorrhage is still a subject of discussion. The objective of this study is to assess the effect of platelet transfusion on mortality in trauma patients who received massive transfusion.MethodsData were collected from four Dutch level-1 trauma centres. All trauma patients aged ≥ 16 years who received ≥ 6 RBC / 6 h from the time of injury were included. Patients were divided based on PLT:RBC ratio (no platelets, low (<1:5) and high (≥1:5)). Primary outcome measure was 6-hour mortality and secondary outcomes included mortality at other time points and transfusion characteristics.ResultsA total of 292 patients were included. Patients in the high PLT ratio group had lower mortality rates at six and 12 h as compared to the low PLT ratio and no PLT group. In the high PLT group mortality as a result of exsanguination (12 %) was significantly lower as compared to the low PLT group (23 %). High PLT ratio had lower probability for 6-hour mortality multivariable analysis. Higher plasma:RBC ratios were associated with lower mortality at all time points.ConclusionsAlthough the optimal patient specific transfusion strategy in patients with traumatic haemorrhage is still not resolved, these results show that higher PLT to RBC ratios are associated with lower early mortality.Copyright © 2024 Elsevier Ltd. All rights reserved.

6 keywords...

hide…