Prehospital whole blood transfusion improves probability of survival over transfusion within one hour of arrival to a trauma center.
American Journal of Surgery · 2025-07-17 · Observational study
Abstract
BACKGROUND: Hemorrhagic shock remains the leading cause of mortality in trauma patients and prehospital whole blood transfusion (PHWBT) improves outcomes in patients with significant shock burden. This study evaluates the impact of PHWBT on the probability of survival (PS) in trauma patients. METHODS: We compared PS determined via the Trauma and Injury Severity Score (TRISS) equation, for patients receiving PHWB and WB within 1 h of arrival to our Level 1 academic trauma center (EDWB). RESULTS: 419 patients (241 PHWB, 178 EDWB) were identified. 54.4 % vs 35.4 % of patients had an improvement in PS (prehospital to on-arrival) and 34.3 % vs 16.6 % (PHWB vs. EDWB, respectively) demonstrated a shock index decline from >1 to <1, p < 0.001. PHWB group had more unexpected survivors, 24 vs. 7 (p = 0.02), corresponding to an estimated $15,725 to produce one additional unexpected survivor through PHWBT. CONCLUSION: PHWBT enhances shock physiology, improves survival probability, and offers a potentially cost-effective investment towards optimizing outcomes in trauma patients with hemorrhagic shock.
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Tags
Blood products · Cost & cost-effectiveness · Fluids & blood · Mortality & survival
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