Trauma Surgeon, Associate Professor, United States
Objectives: Whole blood (WB) for trauma resuscitation in civilian populations has become commonplace. The utilization of WB in community trauma centers has not been reported. We hypothesize that WB based resuscitation compared to component only resuscitation (CORe) would demonstrate a survival benefit.
Methods: A retrospective review of consecutive trauma patients admitted to a community trauma center who received WB or CORe as part of their massive transfusion resuscitation was completed for years 2017-2021. During this period our center incorporated 2 units of WB immediately available for all trauma activations starting in 2019. Patients in the WB group received at least 1 unit of WB and CORe received no WB. Univariate and multivariate analysis were completed.
Results: 576 patients received blood products as part of their resuscitation, 201 in WB and 375 in CORe. Both groups were equally matched with respect to ISS (24.4 vs 25.6), AIS (including head 3 vs 4, chest 3 vs 3, abdomen 3 vs 4 and extremity 3 vs 3), admission physiology (HR 100 vs 100 and SBP 75 vs 81) for WB vs CORe respectively. ABC scores were similar 1.19 vs 1.07 and favored WB but was not significant. No differences were observed in length of stay (LOS), ICU LOS or ventilator days. Odd ratios calculated for survival at discharge (Table 1).
Conclusion: Receiving whole blood during resuscitation conferred a clear survival benefit to discharge. WB should be incorporated into all resuscitation protocols for exsanguinating trauma patients and preferred over component therapy.
