Trends in Transfusion Strategies and Outcomes in Trauma

May 17, 2026 updated by: Mariah Arif

Temporal Trends in Transfusion Strategies and Outcomes in Trauma: A 5-Year Analysis From a Level I Trauma Center

This retrospective cohort study evaluated transfusion practices and outcomes in 137 severely injured trauma patients requiring massive transfusion at a Level I trauma center (2020-2025). This study analyzed balanced transfusion ratios, whole blood (WB) use, thromboelastography (TEG), and adjunctive hemostatic therapies to determine their impact on 30-day mortality and other clinical outcomes.

Study Overview

Status

Completed

Conditions

Study Type

Observational

Enrollment (Actual)

137

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

United States
- Florida
  - Gainesville, Florida, United States, 32611
    - University of Florida Health Trauma One Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Adult
Older Adult

Accepts Healthy Volunteers

Sampling Method

Non-Probability Sample

Study Population

Adult trauma patients (≥18 years) presenting directly to the trauma center were eligible for inclusion if they met at least one of the following criteria:

Injury Severity Score (ISS) ≥16, or
requirement for massive transfusion, defined as >10 units of packed red blood cells (PRBC) within the first 24 hours.

Description

Inclusion Criteria:

Adult trauma patients (≥18 years) presenting directly to the trauma center were eligible for inclusion if they met at least one of the following criteria:

Injury Severity Score (ISS) ≥16, or
requirement for massive transfusion, defined as >10 units of packed red blood cells (PRBC) within the first 24 hours.

Exclusion Criteria:

Death on arrival,
Transfer from external institutions after initial resuscitation
Incomplete transfusion or outcome data
Significant pre-existing comorbidities (including advanced heart failure, end-stage renal disease, cirrhosis with portal hypertension, chronic oxygen dependence, or non-reversible anticoagulation therapy).
Patients with isolated minor injuries not requiring trauma team activation were also excluded.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Number of groups / cohorts

Cohorts and Interventions

Group / Cohort
Whole blood Patients who received whole blood
Not whole blood Patients who did not receive whole blood and instead only blood components

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
30-day all cause mortality Time Frame: 30 days post-transfusion	30 days post-transfusion

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
in-hospital mortality Time Frame: From date of hospital admission until date of death, assessed up to 60 months		From date of hospital admission until date of death, assessed up to 60 months
ICU length of stay Time Frame: from date of ICU admission until date of ICU discharge, assessed up to 60 months		from date of ICU admission until date of ICU discharge, assessed up to 60 months
Hospital length of stay Time Frame: from admission till discharge or death		from admission till discharge or death
Ventilator-free days Time Frame: Within 28 days post-ventilator use		Within 28 days post-ventilator use
Acute kidney injury Time Frame: Increase in serum creatinine by ≥0.3 mg/dL within 48 hours, or Increase in serum creatinine to ≥1.5 times baseline within 7 days, or Urine output <0.5 mL/kg/hour for 6 hours.		Increase in serum creatinine by ≥0.3 mg/dL within 48 hours, or Increase in serum creatinine to ≥1.5 times baseline within 7 days, or Urine output <0.5 mL/kg/hour for 6 hours.
thromboembolic events Time Frame: from date of admission up till date of discharge, assessed up to 60 months	deep vein thrombosis, pulmonary embolism, stroke	from date of admission up till date of discharge, assessed up to 60 months
Number of participants with multiorgan failure Time Frame: From date of hospital admission until date of documented organ failure, assessed unto 60 months	Multiorgan failure (MOF) was defined as dysfunction or failure of two or more organ systems as assessed by the Sequential Organ Failure Assessment (SOFA) score.	From date of hospital admission until date of documented organ failure, assessed unto 60 months
Transfusion related complications Time Frame: Within 6 hours of transfusion	Transfusion related acute lung injury, Transfusion associated circulatory overload	Within 6 hours of transfusion

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Mariah Arif

Investigators

Principal Investigator: ayten saracoglu, University of Florida

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2020

Primary Completion (Actual)

December 31, 2025

Study Completion (Actual)

December 31, 2025

Study Registration Dates

First Submitted

May 8, 2026

First Submitted That Met QC Criteria

May 17, 2026

First Posted (Actual)

May 22, 2026

Study Record Updates

Last Update Posted (Actual)