Efficacy of a high FFP:PRBC transfusion ratio on the survival of severely injured patients: a retrospective study in a single tertiary emergency center in Japan

Surg Today. 2014 Apr;44(4):653-61. doi: 10.1007/s00595-013-0518-4. Epub 2013 Feb 19.

Abstract

Purpose: Recent studies have shown increased survival benefits when a high fresh frozen plasma (FFP) to packed red blood cell (PRBC) ratio is used during trauma resuscitation. However, some reports have raised questions about the effect of higher FFP:PRBC transfusion ratios. The aim of this study was to examine the efficacy of high FFP:PRBC ratios in injured patients with regard to survival and morbidity in a single tertiary emergency center in Japan.

Methods: This study examined severe trauma patients who received 10 or more PRBC units during the first 24 h of admission. We examined the relationship between the FFP:PRBC ratios during the first 6 h and the patient outcome.

Results: The severity was similar among all groups. The mortality rate was 44.4% in the high (>1:1.5), 16.7% in the middle (1:1.5-1:2) and 33.3% in the low (<1:2) F:P ratio groups. Only one patient in the high group developed sepsis, and none of the patients developed ARDS.

Conclusions: The current results indicate that the FFP:PRBC ratios during the first 6 h after admission might not affect the mortality or morbidity. However, differences between trauma care systems in Japan and other countries, along with other study limitations, necessitate that a subsequent prospective multicenter study be undertaken before any definitive conclusions can be made.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital / statistics & numerical data*
  • Erythrocyte Transfusion* / statistics & numerical data
  • Female
  • Hematocrit
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Plasma*
  • Resuscitation / methods*
  • Retrospective Studies
  • Survival Rate
  • Tertiary Care Centers / statistics & numerical data*
  • Time Factors
  • Trauma Severity Indices*
  • Treatment Outcome
  • Wounds and Injuries / mortality*
  • Wounds and Injuries / therapy*