Analysis of Outcomes after Whole Blood Transfusion vs Balanced Component Therapy

Area of Science:

• Trauma care and resuscitation science
• Blood product transfusion efficacy
• Critical care medicine

Background:

• Whole blood (WB) transfusion is often preferred for hemorrhaging trauma patients over component therapy.
• Limited research exists on post-trauma complications comparing WB transfusion to balanced component therapy (BCT).

Purpose of the Study:

• To investigate if WB transfusion leads to decreased morbidity and mortality in trauma patients.
• To compare complication rates between WB transfusion and BCT in trauma care.

Main Methods:

• Analysis of Trauma Quality Improvement Program (TQIP) data from 2018-2021.
• Inclusion of trauma patients receiving blood products within 4 hours; exclusion of pediatric, head/burn injury, or incomplete data patients.
• Propensity matching to compare WB and BCT cohorts (1:1:1 RBC:plasma:platelets for BCT).

Main Results:

• Post-matching, 4,434 patients were analyzed with no demographic differences between WB and BCT groups.
• The WB cohort experienced shorter ICU stays and significantly lower rates of acute kidney injury, ARDS, cardiac arrest, DVT, and unplanned critical care events.
• No significant difference in in-hospital mortality was observed between WB and BCT groups.

Conclusions:

• WB transfusion is linked to fewer complications compared to BCT in trauma patients.
• WB transfusion did not demonstrate an association with improved survival.
• Further research is required to understand the mechanisms behind the reduced complication rates with WB transfusion.