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Blood Transfusion

Blood Transfusion

Blood transfusion is a critical medical procedure that saves lives and treats various medical conditions. It involves transferring blood from a donor to a recipient. This process requires a thorough understanding of the ABO blood group system and its associated antigens and antibodies.
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...

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Updated: Dec 22, 2025

A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy

A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy

Cost-effectiveness evaluation of the PROPPR trial transfusion protocols.

Rachael A Callcut¹, Kit N Simpson², Sarah Baraniuk³

¹Division of General Surgery, Department of Surgery, School of Medicine, University of California San Francisco, San Francisco, California, USA.

|May 3, 2020

Summary

The 1:1:1 transfusion ratio for trauma resuscitation is cost-effective, improving hemostasis and survival. This strategy offers more life-years gained at a reasonable cost per year for severely injured patients.

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Published on: September 6, 2017

Area of Science:

Trauma Resuscitation
Transfusion Medicine
Health Economics

Background:

No prior studies evaluated cost-effectiveness of transfusion strategies in trauma resuscitation.
The Pragmatic, Randomized, Optimal Platelet and Plasma Ratios (PROPPR) study compared 1:1:1 and 1:1:2 ratios of plasma and platelets to red blood cells.
Hypothesis: 1:1:1 ratio is cost-effective using age-specific life expectancy and 30-day trial costs.

Purpose of the Study:

To determine the cost-effectiveness of a 1:1:1 transfusion ratio compared to a 1:1:2 ratio in trauma resuscitation.
To analyze the incremental cost-effectiveness ratio (ICER) of the 1:1:1 strategy.
To evaluate the impact on hemostasis, mortality, and life expectancy.

Main Methods:

Phase III, multisite, randomized trial (PROPPR) with 680 subjects.
International Classification of Diseases, Ninth Revision codes used for cost weighting via matching to Healthcare Utilization Program data.
Decision tree analysis combined with standard costs and estimated survival years.

Main Results:

The 1:1:1 group showed higher costs for blood products but improved hemostasis and reduced hemorrhagic death by 24 hours (p=0.006).
For every 100 patients, 1:1:1 achieved hemostasis in 8 more patients.
At 30 days, 1:1:1 cost $5.6M vs $5.0M for 1:1:2 per 100 patients, yielding 218.5 more life-years at $2994/year gained.

Conclusions:

The 1:1:1 transfusion ratio is a highly cost-effective strategy for severely injured, hemorrhaging trauma patients.
This ratio improves hemostasis and decreases trauma-related deaths.
The strategy provides significant gains in life expectancy at an acceptable incremental cost.