Transfusion ratios and survival in severe blunt trauma patients receiving massive transfusion
Abstract The optimal transfusion ratios for severe blunt trauma requiring massive transfusion remain unclear. This nationwide retrospective cohort study used data from the Japan Trauma Data Bank (2019–2022) and included patients receiving ≥ 10 units of packed red blood cells (pRBC) within 24 h. The...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-07-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-11338-7 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849763568455516160 |
|---|---|
| author | Toru Takiguchi Tomohisa Seki Takashi Tagami Yu Akagi Ryuta Nakae Hiromasa Ito Yoshimasa Kawazoe Ichiro Okada Shiei Kim Masaaki Inoue Kazuhiko Ohe Shoji Yokobori |
| author_facet | Toru Takiguchi Tomohisa Seki Takashi Tagami Yu Akagi Ryuta Nakae Hiromasa Ito Yoshimasa Kawazoe Ichiro Okada Shiei Kim Masaaki Inoue Kazuhiko Ohe Shoji Yokobori |
| author_sort | Toru Takiguchi |
| collection | DOAJ |
| description | Abstract The optimal transfusion ratios for severe blunt trauma requiring massive transfusion remain unclear. This nationwide retrospective cohort study used data from the Japan Trauma Data Bank (2019–2022) and included patients receiving ≥ 10 units of packed red blood cells (pRBC) within 24 h. The fresh frozen plasma (FFP)-to-pRBC and platelet concentrate (PC)-to-pRBC ratios were categorized as 0–0.5, 0.5–1, 1–1.5, 1.5–2, and > 2. Among 2,849 eligible patients, an FFP-to-pRBC ratio of 1–1.5 was associated with significantly higher in-hospital survival than 0.5–1 (adjusted odds ratio [OR], 1.46; 95% confidence interval [CI], 1.12–1.92; P = 0.006). A PC-to-pRBC ratio of 1.5–2 also showed a trend toward improved survival (1.62; 1.00–2.69; P = 0.053). Patients were categorized into three phenotypes: truncal trauma with shock (70.3%), moderate head and extremity trauma (11.8%), and severe head trauma with consciousness disturbances (17.9%). In the truncal trauma with shock phenotype, FFP-to-pRBC ratios of 1–1.5 (1.56; 1.12–2.20; P = 0.010) and > 2 (2.32; 1.14–5.10; P = 0.027) were associated with improved survival. Higher FFP-to-pRBC and PC-to-pRBC ratios may be associated with improved survival, especially in truncal trauma with shock. |
| format | Article |
| id | doaj-art-52761145f75e45ea8a0c695073657ff7 |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-52761145f75e45ea8a0c695073657ff72025-08-20T03:05:22ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-11338-7Transfusion ratios and survival in severe blunt trauma patients receiving massive transfusionToru Takiguchi0Tomohisa Seki1Takashi Tagami2Yu Akagi3Ryuta Nakae4Hiromasa Ito5Yoshimasa Kawazoe6Ichiro Okada7Shiei Kim8Masaaki Inoue9Kazuhiko Ohe10Shoji Yokobori11Department of Emergency and Critical Care Medicine, Nippon Medical SchoolDepartment of Healthcare Information Management, The University of Tokyo HospitalDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolDepartment of Biomedical Informatics, Graduate School of Medicine, The University of TokyoDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolDepartment of Healthcare Information Management, The University of Tokyo HospitalDepartment of Healthcare Information Management, The University of Tokyo HospitalDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolDepartment of Healthcare Information Management, The University of Tokyo HospitalDepartment of Emergency and Critical Care Medicine, Nippon Medical SchoolAbstract The optimal transfusion ratios for severe blunt trauma requiring massive transfusion remain unclear. This nationwide retrospective cohort study used data from the Japan Trauma Data Bank (2019–2022) and included patients receiving ≥ 10 units of packed red blood cells (pRBC) within 24 h. The fresh frozen plasma (FFP)-to-pRBC and platelet concentrate (PC)-to-pRBC ratios were categorized as 0–0.5, 0.5–1, 1–1.5, 1.5–2, and > 2. Among 2,849 eligible patients, an FFP-to-pRBC ratio of 1–1.5 was associated with significantly higher in-hospital survival than 0.5–1 (adjusted odds ratio [OR], 1.46; 95% confidence interval [CI], 1.12–1.92; P = 0.006). A PC-to-pRBC ratio of 1.5–2 also showed a trend toward improved survival (1.62; 1.00–2.69; P = 0.053). Patients were categorized into three phenotypes: truncal trauma with shock (70.3%), moderate head and extremity trauma (11.8%), and severe head trauma with consciousness disturbances (17.9%). In the truncal trauma with shock phenotype, FFP-to-pRBC ratios of 1–1.5 (1.56; 1.12–2.20; P = 0.010) and > 2 (2.32; 1.14–5.10; P = 0.027) were associated with improved survival. Higher FFP-to-pRBC and PC-to-pRBC ratios may be associated with improved survival, especially in truncal trauma with shock.https://doi.org/10.1038/s41598-025-11338-7Transfusion ratioBlunt traumaMassive transfusionClusteringTruncal traumaShock |
| spellingShingle | Toru Takiguchi Tomohisa Seki Takashi Tagami Yu Akagi Ryuta Nakae Hiromasa Ito Yoshimasa Kawazoe Ichiro Okada Shiei Kim Masaaki Inoue Kazuhiko Ohe Shoji Yokobori Transfusion ratios and survival in severe blunt trauma patients receiving massive transfusion Scientific Reports Transfusion ratio Blunt trauma Massive transfusion Clustering Truncal trauma Shock |
| title | Transfusion ratios and survival in severe blunt trauma patients receiving massive transfusion |
| title_full | Transfusion ratios and survival in severe blunt trauma patients receiving massive transfusion |
| title_fullStr | Transfusion ratios and survival in severe blunt trauma patients receiving massive transfusion |
| title_full_unstemmed | Transfusion ratios and survival in severe blunt trauma patients receiving massive transfusion |
| title_short | Transfusion ratios and survival in severe blunt trauma patients receiving massive transfusion |
| title_sort | transfusion ratios and survival in severe blunt trauma patients receiving massive transfusion |
| topic | Transfusion ratio Blunt trauma Massive transfusion Clustering Truncal trauma Shock |
| url | https://doi.org/10.1038/s41598-025-11338-7 |
| work_keys_str_mv | AT torutakiguchi transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion AT tomohisaseki transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion AT takashitagami transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion AT yuakagi transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion AT ryutanakae transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion AT hiromasaito transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion AT yoshimasakawazoe transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion AT ichirookada transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion AT shieikim transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion AT masaakiinoue transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion AT kazuhikoohe transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion AT shojiyokobori transfusionratiosandsurvivalinsevereblunttraumapatientsreceivingmassivetransfusion |