Can Early Aggressive Administration of Fresh Frozen Plasma Improve Outcomes in Patients with Severe Blunt Trauma?—a Report by the Japanese Association for the Surgery of Trauma

• Published in: Shock (Augusta, Ga.) Ga.), 2016-05, Vol.45 (5), p.495-501
• Main Authors: Hagiwara, Akiyoshi, Kushimoto, Shigeki, Kato, Hiroshi, Sasaki, Junichi, Ogura, Hiroshi, Matsuoka, Tetsuya, Uejima, Toshifumi, Hayakawa, Mineji, Takeda, Munekazu, Kaneko, Naoyuki, Saitoh, Daizoh, Otomo, Yasuhiro, Yokota, Hiroyuki, Sakamoto, Teruo, Tanaka, Hiroshi, Shiraishi, Atsushi, Morimura, Naoto, Ishikura, Hiroyasu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood Component Transfusion; Clinical Science Aspects; Erythrocyte Transfusion; Female; Humans; Injury Severity Score; Male; Middle Aged; Plasma - physiology; Proportional Hazards Models; Retrospective Studies; Trauma Centers; Wounds, Nonpenetrating - pathology; Wounds, Nonpenetrating - therapy
• ISSN: 1073-2322; 1540-0514
• DOI: 10.1097/SHK.0000000000000536

BACKGROUND:This 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. METHODS:This 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). RESULTS:The 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