Exploring Differences in Blood Product Administration by Patient Age and Injury Severity

Area of Science:

• Trauma and Emergency Medicine
• Geriatric Medicine
• Hematology

Background:

• Trauma-related hemorrhage is a leading cause of preventable death.
• Current resuscitation guidelines lack age-specific data, impacting all adult age groups.
• This study investigates age-related differences in blood product administration for trauma hemorrhage.

Purpose of the Study:

• To examine age-related variations in packed red blood cell (PRBC) administration.
• To compare PRBC transfusion quantities among different age and injury severity groups in trauma patients.

Main Methods:

• Secondary analysis of the Pragmatic, Randomized Optimal Platelet and Plasma Ratios trial (N=640).
• Patients categorized by age (18-39, 40-59, 60+) and injury severity score (moderate, severe, profound).
• Negative binomial regression analyzed PRBC quantity versus age and injury severity.

Main Results:

• Older adults (60+) with severe injuries received 33% fewer PRBC units than younger adults (18-39) with similar severity (CR, 0.67; P=.031).
• The study included critically injured adults from North American trauma centers.
• Patient demographics: primarily male (80.5%), white (64.5%), with blunt (51.7%) or penetrating injuries (47%).

Conclusions:

• Findings suggest age influences the quantity of blood products administered in trauma hemorrhage.
• Further research is necessary to understand age-specific treatment considerations for trauma resuscitation.