Trial reportThe journal of trauma and acute care surgery2017
Every minute counts: Time to delivery of initial massive transfusion cooler and its impact on mortality.
Trial report in The journal of trauma and acute care surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
92 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Systematic review and meta-analysis of machine learning models predicting massive hemorrhage protocol in trauma.Scientific reports · 2026Pooled it
- Prioritizing circulation over airway to improve survival in trauma patients with exsanguinating injuries: a world society of emergency surgery-panamerican trauma consensus statement.World journal of emergency surgery : WJES · 2025Pooled it
- Association of Anaesthetists guidelines: the use of blood components and their alternatives.Anaesthesia · 2025Guideline
- Shock index as predictor of massive transfusion and mortality in patients with trauma: a systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- Group A emergency-release plasma in trauma patients requiring massive transfusion.The journal of trauma and acute care surgery · 2020Trial
- Patient and surrogate attitudes via an interviewer-administered survey on exception from informed consent enrollment in the Prehospital Air Medical Plasma (PAMPer) trial.BMC emergency medicine · 2020Trial
- Trial
- A comparison of resuscitation intensity and critical administration threshold in predicting early mortality among bleeding patients: A multicenter validation in 680 major transfusion patients.The journal of trauma and acute care surgery · 2018Trial
- Blood supply continuity and emergency preparedness in natural and man-made disasters and in armed conflicts-The Nordic perspectives.Vox sanguinis · 2026Review
- The burden of blast injuries on a level i trauma center: a comparative analysis of blast versus blunt trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Trauma-Induced Coagulopathy: From Endotheliopathy and Fibrinolysis Phenotypes to Viscoelastic-Guided Resuscitation.European journal of haematology · 2026Review
- Development and Validation of a Simplified Five-Variable Score for Predicting Massive Transfusion in Blunt-Trauma-Predominant Patients.Journal of clinical medicine · 2026Article
- Association between time to transfusion and outcomes in patients with traumatic haemorrhagic shock: an analysis of a nationwide trauma registry in Japan.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Early calcium replacement after minimal blood transfusion is associated with adverse outcomes.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Association of an integrated prehospital-to-in-hospital transfusion workflow with early outcomes in severe trauma requiring emergency transfusion: A single-center observational before-and-after study.The Journal of international medical research · 2026Observational
- Alternative models of consent in out-of-hospital transfusion trials: a CAN-PATT position statement supporting exception from prospective consent with opt-out notification.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Cognitive Biases in Early Trauma Transfusions: Lessons From Three Rare Cases of Acute Hemolytic Reaction.Clinical case reports · 2026Article
- Early prediction of transfusion requirements in trauma patients using explainable machine learning.Transfusion · 2026Article
- Review
- Unequal access to timely care: Geographic variation in prehospital time among injured patients at risk of hemorrhagic shock.Transfusion · 2026Article
32 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundAmerican College of Surgeons Trauma Quality Improvement Best Practices recommends initial massive transfusion (MT) cooler delivery within 15 minutes of protocol activation, with a goal of 10 minutes. The current study sought to examine the impact of timing of first cooler delivery on patient outcomes.
methodsPatients predicted to receive MT at 12 Level I trauma centers were randomized to two separate transfusion ratios as described in the PROPPR trial. Assessment of Blood Consumption score or clinician gestalt prediction of MT was used to randomize patients and call for initial study cooler. In this planned subanalysis, the time to MT protocol activation and time to delivery of the initial cooler were evaluated. The impact of these times on mortality and time to hemostasis were examined using both Wilcoxon rank sum and linear and logistic regression.
resultsAmong 680 patients, the median time from patient arrival to MT protocol activation was 9 minutes with a median time from MT activation call to delivery of first cooler of 8 minutes. An increase in both time to MT activation and time to arrival of first cooler were associated with prolonged time to achieving hemostasis (coefficient, 1.09; p = 0.001 and coefficient, 1.16; p < 0.001, respectively). Increased time to MT activation and time to arrival of first cooler were associated with increased mortality (odds ratio [OR], 1.02; p = 0.009 and OR, 1.02; p = 0.012, respectively). Controlling for injury severity, physiology, resuscitation intensity, and treatment arm (1:1:1 vs. 1:1:2), increased time to arrival of first cooler was associated with an increased mortality at 24 hours (OR, 1.05; p = 0.035) and 30 days (OR, 1.05, p = 0.016).
conclusionDelays in MT protocol activation and delays in initial cooler arrival were associated with prolonged time to achieve hemostasis and an increase in mortality. Independent of products ratios, every minute from time of MT protocol activation to time of initial cooler arrival increases odds of mortality by 5%. LEVEL OF EVIDENCE: Prognostic, level II; Therapeutic, level III.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.