Re-evaluation of Blood Product Wastage From Massive Transfusion Protocol at a Level 1 Trauma Center: A Retrospective...

Massive transfusion protocols (MTPs) are essential in the management of traumatic hemorrhage, enabling timely and standardized blood product delivery. This study evaluated whether blood component wastage after MTP activation has decreased compared with previously published institutional data.

We retrospectively reviewed 5072 trauma patients ≥18 y between January 2022 and September 2023, identifying 89 (1.8%) with MTP activation. Demographic and clinical data were analyzed. Wastage rates for packed red blood cells, fresh frozen plasma, and platelets were compared to 2015-2018 institutional data. Transfusion documentation discrepancies between the blood bank and the electronic medical record were also assessed. Continuous variables were analyzed with the Mann-Whitney U test and categorical variables with the chi-square or Fisher's exact test, with significance set at P < 0.05.

Of the 89 patients, 31 (34.8%) had wastage of at least one blood component. There were no significant demographic or clinical differences between patients with and those without wastage, including age, gender, injury type, Glasgow Comma Scale, injury severity score, MTP time, complications, discharge disposition, or mortality. Compared to previously published data, wastage significantly decreased for packed red blood cells (2.2% versus 1.2%), fresh frozen plasma (5.7% versus 2.3%), and platelets (13.7% versus 2.9%), all P < 0.001. Documentation discrepancies occurred in 88.7% of activations, with 25.8% involving >10-unit mismatches.

MTP blood product wastage has significantly decreased, reflecting sustained quality improvement. However, high documentation discrepancies highlight a critical target for process improvement.