Postresuscitation platelet transfusion in major trauma patients
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Authors
Rossetto A.
Reynolds J.
Ykema E.
Davenport R.
Cole E.
Vulliamy,P.
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Issue Date
2025
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Article
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Background: Platelet transfusions (PLT-t) are a cornerstone of contemporary trauma resuscitation, but little is known about their use in the postresuscitation period. Our aims were to describe the utilization of PLT-t after resuscitation and examine their impact on platelet count and clinical outcomes. Study Design and Methods: Adult trauma patients admitted to critical care at a single major trauma center were included. We compared patients who received PLT-t postresuscitation (>24 h after injury) with those who did not and examined platelet increments before and after each individual PLT-t episode. Logistic regressions were constructed to examine the association between postresuscitation PLT-t and clinical outcomes. Result(s): This study included 803 injured patients, of whom 109 (14%) received at least one PLT-t after resuscitation. Overall, 30% (221/725) of all platelet units administered to the cohort were given in the postresuscitation phase, most in the first week of admission and to patients with moderate-severe thrombocytopenia. The median platelet count increment following transfusion was 19 x 109/L (interquartile range 1-30), and 24% of transfusions failed to increase the platelet count within 24 h. Postresuscitation PLT-t in patients with moderate-severe thrombocytopenia was independently associated with reduced mortality (OR 0.42, p =.039) but a longer critical care length of stay among survivors (coefficient 0.35, p =.007). Conclusion(s): Postresuscitation PLT-t is frequently administered in trauma patients. The impact on platelet counts is variable, likely attributable to differences in timing and pretransfusion platelet count. After adjusting for relevant confounders, postresuscitation PLT-t was associated with reduced mortality in this cohort. Copyright © 2025 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB.
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Transfusion
Volume
65
Issue
11