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Trends in massive transfusion practice for trauma in Japan from 2011 to 2020: a nationwide inpatient database study
BACKGROUND: Previous studies have reported conflicting results regarding fresh frozen plasma (FFP)-to-red blood cell (RBC) ratio and platelet-to-RBC ratio on outcomes for massive transfusion for trauma. Moreover, nationwide data on massive transfusion practices for trauma in the real-world clinical...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10585788/ https://www.ncbi.nlm.nih.gov/pubmed/37853484 http://dx.doi.org/10.1186/s40560-023-00685-0 |
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author | Ohbe, Hiroyuki Tagami, Takashi Endo, Akira Miyata, Shigeki Matsui, Hiroki Fushimi, Kiyohide Kushimoto, Shigeki Yasunaga, Hideo |
author_facet | Ohbe, Hiroyuki Tagami, Takashi Endo, Akira Miyata, Shigeki Matsui, Hiroki Fushimi, Kiyohide Kushimoto, Shigeki Yasunaga, Hideo |
author_sort | Ohbe, Hiroyuki |
collection | PubMed |
description | BACKGROUND: Previous studies have reported conflicting results regarding fresh frozen plasma (FFP)-to-red blood cell (RBC) ratio and platelet-to-RBC ratio on outcomes for massive transfusion for trauma. Moreover, nationwide data on massive transfusion practices for trauma in the real-world clinical setting are scarce. This study aimed to examine the nationwide practice patterns and trends in massive transfusion for trauma in Japan using a national administrative, inpatient database. METHOD: We identified patients who underwent emergency hospitalization for trauma and received massive transfusion, defined as administration of at least 20 units of RBC within the first 2 days of admission, using the nationwide inpatient database, which covers approximately 90% of all tertiary emergency hospitals in Japan, between 2011 and 2020. Trends in the incidence and practice patterns of massive transfusion were described by calendar year. The association of practice patterns with mortality or adverse events was tested. RESULTS: A total of 3,530,846 trauma hospitalizations were identified, of which 5247 (0.15%) received massive transfusion. A significant declining trend was observed in the incidence of massive transfusion in trauma hospitalizations from 0.24% in 2011 to 0.10% in 2020 (P for trend < 0.001). The FFP-to-RBC ratio rose significantly from 0.77 in 2011 to 1.08 in 2020 (P for trend < 0.001), while the platelet-to-RBC ratio remained virtually unchanged from 0.71 in 2011 to 0.78 in 2020 (P for trend 0.060). Massive transfusion with lower FFP-to-RBC (< 0.75) and platelets-to-RBC ratio (< 1.00) were associated with increased in-hospital mortality compared with those ≥ 1.00, while there were linear increases in adverse events with increasing FFP and platelets ratios. CONCLUSIONS: This study demonstrated a declining trend in the incidence and a rise in higher FFP-to-RBC ratios in massive transfusion in association with patient outcomes for trauma from 2011 to 2020 in Japan. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40560-023-00685-0. |
format | Online Article Text |
id | pubmed-10585788 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105857882023-10-20 Trends in massive transfusion practice for trauma in Japan from 2011 to 2020: a nationwide inpatient database study Ohbe, Hiroyuki Tagami, Takashi Endo, Akira Miyata, Shigeki Matsui, Hiroki Fushimi, Kiyohide Kushimoto, Shigeki Yasunaga, Hideo J Intensive Care Research BACKGROUND: Previous studies have reported conflicting results regarding fresh frozen plasma (FFP)-to-red blood cell (RBC) ratio and platelet-to-RBC ratio on outcomes for massive transfusion for trauma. Moreover, nationwide data on massive transfusion practices for trauma in the real-world clinical setting are scarce. This study aimed to examine the nationwide practice patterns and trends in massive transfusion for trauma in Japan using a national administrative, inpatient database. METHOD: We identified patients who underwent emergency hospitalization for trauma and received massive transfusion, defined as administration of at least 20 units of RBC within the first 2 days of admission, using the nationwide inpatient database, which covers approximately 90% of all tertiary emergency hospitals in Japan, between 2011 and 2020. Trends in the incidence and practice patterns of massive transfusion were described by calendar year. The association of practice patterns with mortality or adverse events was tested. RESULTS: A total of 3,530,846 trauma hospitalizations were identified, of which 5247 (0.15%) received massive transfusion. A significant declining trend was observed in the incidence of massive transfusion in trauma hospitalizations from 0.24% in 2011 to 0.10% in 2020 (P for trend < 0.001). The FFP-to-RBC ratio rose significantly from 0.77 in 2011 to 1.08 in 2020 (P for trend < 0.001), while the platelet-to-RBC ratio remained virtually unchanged from 0.71 in 2011 to 0.78 in 2020 (P for trend 0.060). Massive transfusion with lower FFP-to-RBC (< 0.75) and platelets-to-RBC ratio (< 1.00) were associated with increased in-hospital mortality compared with those ≥ 1.00, while there were linear increases in adverse events with increasing FFP and platelets ratios. CONCLUSIONS: This study demonstrated a declining trend in the incidence and a rise in higher FFP-to-RBC ratios in massive transfusion in association with patient outcomes for trauma from 2011 to 2020 in Japan. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40560-023-00685-0. BioMed Central 2023-10-18 /pmc/articles/PMC10585788/ /pubmed/37853484 http://dx.doi.org/10.1186/s40560-023-00685-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Ohbe, Hiroyuki Tagami, Takashi Endo, Akira Miyata, Shigeki Matsui, Hiroki Fushimi, Kiyohide Kushimoto, Shigeki Yasunaga, Hideo Trends in massive transfusion practice for trauma in Japan from 2011 to 2020: a nationwide inpatient database study |
title | Trends in massive transfusion practice for trauma in Japan from 2011 to 2020: a nationwide inpatient database study |
title_full | Trends in massive transfusion practice for trauma in Japan from 2011 to 2020: a nationwide inpatient database study |
title_fullStr | Trends in massive transfusion practice for trauma in Japan from 2011 to 2020: a nationwide inpatient database study |
title_full_unstemmed | Trends in massive transfusion practice for trauma in Japan from 2011 to 2020: a nationwide inpatient database study |
title_short | Trends in massive transfusion practice for trauma in Japan from 2011 to 2020: a nationwide inpatient database study |
title_sort | trends in massive transfusion practice for trauma in japan from 2011 to 2020: a nationwide inpatient database study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10585788/ https://www.ncbi.nlm.nih.gov/pubmed/37853484 http://dx.doi.org/10.1186/s40560-023-00685-0 |
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