• Akiyoshi Hagiwara, Shigeki Kushimoto, Hiroshi Kato, Junichi Sasaki, Hiroshi Ogura, Tetsuya Matsuoka, Toshifumi Uejima, Mineji Hayakawa, Munekazu Takeda, Naoyuki Kaneko, Daizoh Saitoh, Yasuhiro Otomo, Hiroyuki Yokota, Teruo Sakamoto, Hiroshi Tanaka, Atsushi Shiraishi, Naoto Morimura, and Hiroyasu Ishikura.
• *Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, Tokyo †Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai ‡Department of Critical Care and Traumatology, National Hospital Organization Disaster Medical Center, Tokyo §Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo ||Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka ¶Senshu Trauma and Critical Care Center, Rinku General Medical Center, Osaka #Department of Emergency and Critical Care Medicine, Kindai University Faculty of Medicine, Nara **Emergency and Critical Care Center, Hokkaido University Hospital, Hokkaido ††Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University, Tokyo ‡‡Trauma and Emergency Center, Fukaya Red Cross Hospital, Fukaya §§Division of Traumatology, Research Institute, National Defense Medical College, Saitama ||||Department of Acute Critical Care and Disaster Medicine, Graduate School of Medical and Dental Sciences, Kagoshima ¶¶Department of Emergency and Critical Care Medicine, Nippon Medical School Graduate School of Medicine, Tokyo ##Department of Emergency and Critical Care Medicine, Kurume University School of Medicine, Kurume ***Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Urayasu †††Trauma and Acute Critical Care Medical Center, Tokyo Medical and Dental University Hospital of Medicine, Tokyo ‡‡‡Department of Emergency Medicine, Yokohama City University Graduate School of Medicine, Yokohama §§§Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
• Shock. 2016 May 1; 45 (5): 495-501.

BackgroundThis study investigated the effect of a high ratio of fresh frozen plasma (FFP) to red blood cells (RBCs) within the first 6 and 24  h after admission on mortality in patients with severe, blunt trauma.MethodsThis retrospective observational study included 189 blunt trauma patients with an Injury Severity Score (ISS) ≥16 requiring RBC transfusions within the first 24  h. Receiver operating characteristic (ROC) curve analysis was performed to calculate cut-off values of the FFP/RBC ratio for outcome. The patients were then divided into two groups according to the cut-off value. Patient survival was compared between groups using propensity score matching (PSM).ResultsThe area under the ROC curve was 0.57, and the FFP/RBC ratio was 1.0 at maximum sensitivity (0.57) and specificity (0.67). All patients were then divided into two groups (FFP/RBC ratio ≥1 or <1) and analyzed using PSM and inverse probability of treatment weighting (IPTW). The unadjusted hazard ratio (HR) was 0.44, and the adjusted HR was 0.29. The HR was 0.38 by PSM and 0.41 by IPTW. The survival rate was significantly higher in patients with an FFP/RBC ratio ≥1 within the first 6  h.ConclusionsSevere blunt trauma patients transfused with an FFP/RBC ratio ≥1 within the first 6  h had an HR of about 0.4. The transfusion of an FFP/RBC ratio ≥1 within the first 6  h was associated with the outcomes of blunt trauma patients with ISS ≥16 who need a transfusion within 24  h.

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