T. Orouji Jokar1, B. Zangbar1, P. Rhee1, N. Kulvatunyou1, M. Khalil1, T. O’Keeffe1, A. Tang1, R. Latifi1, D. J. Green1, R. S. Friese1, B. Joseph1 1University Of Arizona,Trauma/Surgery/Medicine,Tucson, AZ, USA
Introduction:
The use of 1:1:1 (packed red blood cells (PRBC): fresh frozen plasma (FFP): platelets) transfusion ratios has been shown to improve survival in severely injured trauma patients. The aim of this study was to assess outcomes in patients with traumatic brain injury (TBI) receiving 1:1:1 ratio based blood product transfusion (RBT). We hypothesized that RBT improves survival in patients with TBI.
Methods:
We performed a 3 year retrospective analysis of all patients with an isolated TBI and an intracranial hemorrhage (ICH) presenting to our level 1 trauma center. Patients receiving blood transfusion were included. Patients were stratified into two groups: patients who received RBT and patients those who did not receive RBT (No-RBT). The outcome measure was survival. Multivariate logistic regression analysis was performed.
Results:
A total of 189 patients were included of which; 29% (n=55) received RBT. The mean age was 46.7±24.1 years, median Glasgow Coma Scale (GCS) score was 10 [3-15], and median head abbreviated injury severity scale (h-AIS) score was 3[3-5]. The overall survival rate was 71% (n=135). Patients in the RBT group had a higher survival rate compared to patients in the No-RBT group (78.2% vs. 68.6%, p=0.03).
Conclusion:
The survival benefit of ratio based transfusion exists even in patients with isolated TBI. Guidelines for the initial management of TBI patients should focus on the use of RBT. The beneficial effects of platelets in RBT among TBI patients require further evaluation.
