Nationwide estimates of potential lives saved with prehospital blood transfusions

被引:0
作者
Lammers, Daniel T. [1 ,2 ]
Betzold, Richard [3 ]
Henry, Reynold [4 ]
Dilday, Joshua [5 ]
Conner, Jeffrey R. [6 ]
Williams, James M. [7 ]
Mcclellan, John M. [1 ]
Eckert, Matthew J. [1 ]
Jansen, Jan O. [2 ]
Kerby, Jeffrey [2 ]
Holcomb, John B. [2 ]
Hashmi, Zain G. [2 ]
机构
[1] Univ North Carolina, Med Ctr, 101 Manning Dr, Chapel Hill, NC 27514 USA
[2] Univ Alabama Birmingham, Ctr Injury Sci, Med Ctr, Birmingham, AL USA
[3] UNIV ARKANSAS, Med Sch, LITTLE ROCK, AR USA
[4] Univ Nebraska Med Ctr, Omaha, NE USA
[5] Med Coll Wisconsin, Milwaukee, WI USA
[6] Wake Forest Baptist Med Ctr, Winston Salem, NC USA
[7] Madigan Army Med Ctr, Tacoma, WA USA
关键词
blood transfusion; hemorrhagic shock; prehospital; prehospital blood products; DAMAGE CONTROL RESUSCITATION; TRAUMA PATIENTS; WHOLE-BLOOD; HEMORRHAGIC-SHOCK; UNITED-STATES; DEATH; MORTALITY; IMPACT; ASSOCIATION; PLASMA;
D O I
10.1111/trf.18174
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Prehospital blood transfusions result in a significant reduction in mortality risk for injured patients in hemorrhagic shock; however, prehospital blood transfusions have not been widely implemented across the United States. Thus, a paucity of data surrounding the impact of achieving near-complete population-level access to this resource exists. We aimed to determine the number of lives that could potentially have been saved among injured patients in hemorrhagic shock between 2020 and 2023 had prehospital blood products (blood components or whole blood, pBP) been fully implemented. Methods: We performed a retrospective review of the National Emergency Medical Services Information System (NEMSIS) from 2020 to 2023 for all trauma patients >= 16 years. Patients with prehospital systolic blood pressure <90 mmHg and heart rate >108 beats per minute, or a systolic blood pressure <70 mmHg, and who did not receive pBP products were included in the analysis. Potential lives saved were calculated using mortality and risk ratio estimates (RR) from previously published studies, assuming 100% nationwide access to pBP. A series of models were developed incorporating varying RR, mortality rate assumptions, and nationwide access to pBP to encompass a wide range of scenarios. Results: A total of 260,472 patients met our inclusion criteria. Using a 22.1% 24-h mortality rate and an RR of 0.629, 21,356 deaths over the four-year study period could have potentially been saved with the nationwide implementation of pBP. Conclusion: Transfusion of pBP offers the potential to save thousands of injured patients lives. Efforts toward making policy-level interventions aimed at increasing the adoption and availability of pBP should be sought.
引用
收藏
页码:S14 / S22
页数:9
相关论文
共 42 条
  • [11] Death on the battlefield (2001-2011): Implications for the future of combat casualty care
    Eastridge, Brian J.
    Mabry, Robert L.
    Seguin, Peter
    Cantrell, Joyce
    Tops, Terrill
    Uribe, Paul
    Mallett, Olga
    Zubko, Tamara
    Oetjen-Gerdes, Lynne
    Rasmussen, Todd E.
    Butler, Frank K.
    Kotwal, Russell S.
    Holcomb, John B.
    Wade, Charles
    Champion, Howard
    Lawnick, Mimi
    Moores, Leon
    Blackbourne, Lorne H.
    [J]. JOURNAL OF TRAUMA AND ACUTE CARE SURGERY, 2012, 73 : S431 - S437
  • [12] EARLIER ENDPOINTS ARE REQUIRED FOR HEMORRHAGIC SHOCK TRIALS AMONG SEVERELY INJURED PATIENTS
    Fox, Erin E.
    Holcomb, John B.
    Wade, Charles E.
    Bulger, Eileen M.
    Tilley, Barbara C.
    [J]. SHOCK, 2017, 47 (05): : 567 - 573
  • [13] Gurney JM., 2023, J Trauma Acute Care Surg, V97, pS31
  • [14] Prehospital Blood Product and Crystalloid Resuscitation in the Severely Injured Patient A Secondary Analysis of the Prehospital Air Medical Plasma Trial
    Guyette, Francis X.
    Sperry, Jason L.
    Peitzman, Andrew B.
    Billiar, Timothy R.
    Daley, Brian J.
    Miller, Richard S.
    Harbrecht, Brian G.
    Claridge, Jeffrey A.
    Putnam, Tyler
    Duane, Therese M.
    Phelan, Herb A.
    Brown, Joshua B.
    [J]. ANNALS OF SURGERY, 2021, 273 (02) : 358 - 364
  • [15] Prehospital low titer group O whole blood is feasible and safe: Results of a prospective randomized pilot trial
    Guyette, Frank X.
    Zenati, Mazen
    Triulzi, Darrell J.
    Yazer, Mark H.
    Skroczky, Hunter
    Early, Barbara J.
    Adams, Peter W.
    Brown, Joshua B.
    Alarcon, Louis
    Neal, Matthew D.
    Forsythe, Raquel M.
    Zuckerbraun, Brian S.
    Peitzman, Andrew B.
    Billiar, Timothy R.
    Sperry, Jason L.
    [J]. JOURNAL OF TRAUMA AND ACUTE CARE SURGERY, 2022, 92 (05) : 839 - 847
  • [16] Nationwide estimates of the need for prehospital blood products after injury
    Hashmi, Zain G.
    Jansen, Jan O.
    Kerby, Jeffrey D.
    Holcomb, John B.
    [J]. TRANSFUSION, 2022, 62 : S203 - S210
  • [17] Whole truths but half the blood: Addressing the gap between the evidence and practice of pre-hospital and in-hospital blood product use for trauma resuscitation
    Hashmi, Zain G.
    Chehab, Mohamad
    Nathens, Avery B.
    Joseph, Bellal
    Bank, Eric A.
    Jansen, Jan O.
    Holcomb, John B.
    [J]. TRANSFUSION, 2021, 61 : S348 - S353
  • [18] Making blood immediately available in emergencies
    Holcomb, John B.
    Butler, Frank K.
    Schreiber, Martin A.
    Taylor, Audra L.
    Riggs, Leslie E.
    Krohmer, Jon R.
    Dorlac, Warren C.
    Jenkins, Donald H.
    Cox, Daniel B.
    Beckett, Andrew N.
    O'Connor, Kevin C.
    Gurney, Jennifer M.
    [J]. TRANSFUSION, 2024, 64 (08) : 1543 - 1550
  • [19] Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 vs a 1:1:2 Ratio and Mortality in Patients With Severe Trauma The PROPPR Randomized Clinical Trial
    Holcomb, John B.
    Tilley, Barbara C.
    Baraniuk, Sarah
    Fox, Erin E.
    Wade, Charles E.
    Podbielski, Jeanette M.
    del Junco, Deborah J.
    Brasel, Karen J.
    Bulger, Eileen M.
    Callcut, Rachael A.
    Cohen, Mitchell Jay
    Cotton, Bryan A.
    Fabian, Timothy C.
    Inaba, Kenji
    Kerby, Jeffrey D.
    Muskat, Peter
    O'Keeffe, Terence
    Rizoli, Sandro
    Robinson, Bryce R. H.
    Scalea, Thomas M.
    Schreiber, Martin A.
    Stein, Deborah M.
    Weinberg, Jordan A.
    Callum, Jeannie L.
    Hess, John R.
    Matijevic, Nena
    Miller, Christopher N.
    Pittet, Jean-Francois
    Hoyt, David B.
    Pearson, Gail D.
    Leroux, Brian
    van Belle, Gerald
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2015, 313 (05): : 471 - 482
  • [20] Time to Whole Blood Transfusion in Hemorrhaging Civilian Trauma Patients: There Is Always Room for Improvement
    Hosseinpour, Hamidreza
    Magnotti, Louis J.
    Bhogadi, Sai Krishna
    Anand, Tanya
    El-Qawaqzeh, Khaled
    Ditillo, Michael
    Colosimo, Christina
    Spencer, Audrey
    Nelson, Adam
    Joseph, Bellal
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2023, 237 (01) : 24 - 34