Blood transfusion: In the air tonight?

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Critical Care

Background:

• Prehospital blood transfusion (PBT) is increasingly utilized in air medical transport.
• The clinical impact of PBT on patient outcomes remains largely undetermined.

Purpose of the Study:

• To investigate the effect of PBT on 24-hour and overall in-hospital mortality in trauma patients.
• To analyze the association between PBT and mortality outcomes in a real-world air medical transport setting.

Main Methods:

• Retrospective cohort study of trauma patients transported by air medical services (2007-2013).
• Exclusion of patients with immediate in-hospital death.
• Multivariable logistic regression and propensity score matching were used to analyze PBT's effect on mortality.

Main Results:

• Of 5,581 patients, 4% received PBT.
• No significant association was found between PBT and 24-hour mortality (OR, 1.22) or overall in-hospital mortality (OR, 1.20).
• Propensity score-matched analysis also revealed no significant effect of PBT on mortality outcomes.

Conclusions:

• This study, the largest of its kind, found no evidence that PBT impacts mortality in trauma patients receiving air medical transport.
• Findings contrast with damage-control resuscitation principles, highlighting the need for prospective studies.
• Further research is recommended to evaluate the risks, costs, and benefits of PBT.