Table 3.
Interventions and outcomes among hemodynamically unstable patients with severe trauma
| Variable |
Total (n = 120) |
Before (n = 47) |
After (n = 73) |
P‐value |
|---|---|---|---|---|
| Time from admission to initiate hemostasis, min; median (IQR 25–75) | 56.0 (37.0–88.5) | 50.0 (31.5–107.5) | 57.0 (40.0–75.0) | 0.847 |
| Transfusions given before hemostasis initiation, units; median (IQR 25–75) | ||||
| PRBC | 4.0 (2.0–8.0) | 6.0 (4.0–8.0) | 4.0 (0.0–4.0) | <0.001 |
| FFP | 0.0 (0.0–2.0) | 4.0 (2.0–6.0) | 0.0 (0.0–0.0) | <0.001 |
| Ratio of FFP : PRBC before initiation hemostasis | 0.0 (0.0–0.5) | 0.5 (0.3–0.8) | 0.0 (0.0–0.0) | <0.001 |
| Total amount of blood transfusions in the first 6 h, units, median (IQR 25–75) | ||||
| PRBC | 12.0 (6.0–20.0) | 12.0 (8.0–20.0) | 12.0 (6.0–20.0) | 0.633 |
| FFP | 8.0 (4.0–14.0) | 10.0 (4.0–14.0) | 8.0 (2.0–14.0) | 0.156 |
| Ratio of FFP: PRBC in the first 6 h | 0.7 (0.4–0.9) | 0.8 (0.6–1.0) | 0.6 (0.4–0.8) | 0.005 |
| Total amount of blood transfusion in the first 24 h, units; median (IQR 25–75) | ||||
| PRBC | 16.0 (8.0–24.0) | 18.0 (10.0–26.0) | 14.0 (6.0–22.0) | 0.142 |
| FFP | 10.0 (4.0–19.5) | 12.0 (8.0–22.0) | 8.0 (4.0–18.0) | 0.028 |
| Ratio of FFP : PRBC in the first 24 h | 0.7 (0.4–1.0) | 0.8 (0.6–1.0) | 0.6 (0.4–0.8) | <0.001 |
| Platelets | 10.0 (0.0–20.0) | 10.0 (0.0–30.0) | 0.0 (0.0–20.0) | 0.375 |
| Massive transfusion (≥10 units of RBC during 24 h) (%) | 82 (68.3) | 37 (78.7) | 45 (61.6) | 0.050 |
| PRBC given in the first 24 h following hemostasis initiation, units; median (IQR 25–75) | 8.0 (4.0–18.0) | 8.0 (2.0–18.0) | 8.0 (4.0–20.0) | 0.196 |
| Post‐PRBC : total PRBC; median (IQR 25–75) | 0.7 (0.5–0.9) | 0.6 (0.1–0.8) | 0.8 (0.5–1.0) | <0.001 |
| Complications (%) | ||||
| MOF (Denver score >3) | 6 (5.0) | 3 (6.4) | 3 (4.1) | 0.678 |
| ALI | 22 (18.3) | 10 (21.3) | 12 (16.4) | 0.504 |
| Allergic reaction or transfusion‐related reaction | 3 (2.5) | 1 (2.1) | 2 (2.7) | — |
| 24‐h survival (%) | 87 (72.5) | 37 (78.7) | 50 (68.5) | 0.221 |
| Survival to discharge (%) | 61 (50.8) | 24 (51.1) | 37 (50.7) | 0.968 |
After, plasma transfusion initiated after hemostasis initiation; ALI, acute lung injury; Before, plasma transfusion initiated before hemostasis initiation; FFP, fresh frozen plasma; IQR, interquartile range; MOF, multiple organ failure; PRBC, packed red blood cells; Post‐PRBC, PRBC volume transfused in first 24 h after initiation of hemostasis; total PRBC, total amount of PRBC in the first 24 h; RBC, red blood cells.