Infection Is Not Associated With Plasma or Cryoprecipitate Transfusion Volumes in Trauma: A Retrospective Study Using...

Area of Science:

• Trauma Surgery
• Infectious Disease Epidemiology
• Blood Transfusion Medicine

Background:

• Packed red blood cell (PRBC) transfusions are linked to increased nosocomial infections in trauma patients.
• The infectious risk associated with non-PRBC blood products like plasma and platelets is not well-established.

Purpose of the Study:

• To investigate the association between fresh frozen plasma (FFP), platelet (PLT), and cryoprecipitate transfusions and the risk of nosocomial infections in trauma patients.
• To test the hypothesis that these blood products do not increase infection rates.

Main Methods:

• Retrospective, matched case-control study using the 2019 American College of Surgeons National Trauma Data Bank.
• Inclusion of trauma patients receiving PRBCs within four hours of presentation.
• Matching of 1,563 infectious cases with 3,920 non-infectious controls.
• Bivariable and multivariable logistic regression analyses of transfusion volumes and infection development.

Main Results:

• First four-hour transfusion volumes for FFP and cryoprecipitate were similar between infection and control groups.
• Platelet transfusion volume in the first four hours was lower in patients who developed infections compared to controls (OR, 0.92; P=.01).
• FFP and cryoprecipitate volumes were not significantly associated with infection risk.

Conclusions:

• Fresh frozen plasma, platelet, and cryoprecipitate transfusions are not independent risk factors for nosocomial infections in trauma patients.
• Platelet transfusion volume may be associated with a reduced risk of infection in this population.