title: Efficacy of a high FFP:PRBC transfusion ratio on the survival of severely injured patients: a retrospective study in a single tertiary emergency center in Japan.
abstract: OBJECTIVE
  Recent studies have shown increased survival benefits when a high fresh frozen plasma (FFP) to packed red blood cell (PRBC) ratio is used during trauma resuscitation. However, some reports have raised questions about the effect of higher FFP:PRBC transfusion ratios. The aim of this study was to examine the efficacy of high FFP:PRBC ratios in injured patients with regard to survival and morbidity in a single tertiary emergency center in Japan.
  
  
  METHODS
  This study examined severe trauma patients who received 10 or more PRBC units during the first 24 h of admission. We examined the relationship between the FFP:PRBC ratios during the first 6 h and the patient outcome.
  
  
  RESULTS
  The severity was similar among all groups. The mortality rate was 44.4% in the high (>1:1.5), 16.7% in the middle (1:1.5-1:2) and 33.3% in the low (<1:2) F:P ratio groups. Only one patient in the high group developed sepsis, and none of the patients developed ARDS.
  
  
  CONCLUSIONS
  The current results indicate that the FFP:PRBC ratios during the first 6 h after admission might not affect the mortality or morbidity. However, differences between trauma care systems in Japan and other countries, along with other study limitations, necessitate that a subsequent prospective multicenter study be undertaken before any definitive conclusions can be made.
authors: Emergency Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan, kudodaisuke@med.tohoku.ac.jp.
authors: Daisuke
authors: D
authors: Kudo
authors: Junichi
authors: J
authors: Sasaki
authors: Satoshi
authors: S
authors: Akaishi
authors: Satoshi
authors: S
authors: Yamanouchi
authors: Tomoaki
authors: T
authors: Koakutsu
authors: Tomoyuki
authors: T
authors: Endo
authors: Takeaki
authors: T
authors: Sato
authors: Ryosuke
authors: R
authors: Nomura
authors: Hironao
authors: H
authors: Yuzawa
authors: Michio
authors: M
authors: Kobayashi
authors: Yotaro
authors: Y
authors: Shinozawa
authors: Shigeki
authors: S
authors: Kushimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005260:Female; D006400:Hematocrit; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010949:Plasma; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D013997:Time Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000401:mortality* / Q000628:therapy*