ArticleThe journal of trauma and acute care surgery2020
Prehospital plasma in injured patients is associated with survival principally in blunt injury: Results from two randomized prehospital plasma trials.
Article in The journal of trauma and acute care surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
31 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Prehospital plasma transfusion versus standard of care following traumatic injury: a review of the systematic reviews and a meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Prehospital coagulation management and fluid replacement therapy in patients with multiple and/or severe injuries - A systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Inhospital coagulation management and fluid replacement therapy in patients with multiple and/or severe injuries - a systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- The efficacy and safety of pre-hospital plasma in patients at risk for hemorrhagic shock: an updated systematic review and meta-analysis of randomized controlled trials.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Pooled it
- The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition.Critical care (London, England) · 2023Guideline
- Trial
- Prehospital Lyophilized Plasma Transfusion for Trauma-Induced Coagulopathy in Patients at Risk for Hemorrhagic Shock: A Randomized Clinical Trial.JAMA network open · 2022Trial
- Characterization of unexpected survivors following a prehospital plasma randomized trial.The journal of trauma and acute care surgery · 2020Trial
- Association of Prehospital Plasma With Survival in Patients With Traumatic Brain Injury: A Secondary Analysis of the PAMPer Cluster Randomized Clinical Trial.JAMA network open · 2020Trial
- Forgot calcium? Admission ionized-calcium in two civilian randomized controlled trials of prehospital plasma for traumatic hemorrhagic shock.The journal of trauma and acute care surgery · 2020Trial
- Prehospital plasma is associated with distinct biomarker expression following injury.JCI insight · 2020Trial
- Unequal access to timely care: Geographic variation in prehospital time among injured patients at risk of hemorrhagic shock.Transfusion · 2026Article
- Article
- Characteristics, Regional Evaluation, and D-Antigen in Transfusions by Emergency Medical Services.JAMA network open · 2025Article
- Is Mechanism a Biological Variable?: A Secondary Analysis of the PROPPR Trial.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Recent Advances in Prehospital and In-Hospital Management of Patients with Severe Trauma.Journal of clinical medicine · 2025Review
- High-dimensional analysis of injured patients reveals distinct circulating proteomic profiles in plasma vs. whole blood resuscitation.Cell reports. Medicine · 2025Article
- An Overview of Adult Acute Traumatic Neurologic Injury for the Anesthesiologist:Current anesthesiology reports · 2025Article
- [Prehospital blood transfusion : Opportunities and challenges for the German emergency medical services].Die Anaesthesiologie · 2024Review
- Mechanism matters: mortality and endothelial cell damage marker differences between blunt and penetrating traumatic injuries across three prehospital clinical trials.Scientific reports · 2024Article
Corrections and comments
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Authors and funding
18 authors.
Funding
Abstract
introductionRecent evidence demonstrated that prehospital plasma in patients at risk of hemorrhagic shock was safe for ground transport and resulted in a 28-day survival benefit for air medical transport patients. Whether any beneficial effect of prehospital plasma varies across injury mechanism remains unknown.
methodsWe performed a secondary analysis using a harmonized data set derived from two recent prehospital plasma randomized trials. Identical inclusion/exclusion criteria and primary/secondary outcomes were used for the trials. Prehospital time, arrival shock parameters, and 24-hour transfusion requirements were compared across plasma and control groups stratified by mechanism of injury. Stratified survival analysis and Cox hazard regression were performed to determine the independent survival benefits of plasma across blunt and penetrating injury.
resultsBlunt patients had higher injury severity, were older, and had a lower Glasgow Coma Scale. Arrival indices of shock and coagulation parameters were similar across blunt and penetrating injury. The percentage of patients with a prehospital time less than 20 minutes was significantly higher for penetrating patients relative to blunt injured patients (28.0% vs. 11.6%, p < 0.01). Stratified Kaplan-Meier curves demonstrated a significant separation for blunt injured patients (n = 465, p = 0.01) with no separation demonstrated for penetrating injured patients (n = 161, p = 0.60) Stratified Cox hazard regression verified, after controlling for all important confounders, that prehospital plasma was associated with a 32% lower independent hazard for 28-day mortality in blunt injured patients (hazard ratio, 0.68; 95% confidence interval, 0.47-0.96; p = 0.03) with no independent survival benefit found in penetrating patients (hazard ratio, 1.16; 95% confidence interval, 0.4-3.1; p = 0.78).
conclusionA survival benefit associated with prehospital plasma at 24 hours and 28 days exists primarily in blunt injured patients with no benefit shown in penetrating trauma patients. No detrimental effects attributable to plasma are demonstrated in penetrating injury. These results have important relevance to military and civilian trauma systems. LEVEL OF EVIDENCE: Therapeutic, I.
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