Evidence map›Paper›PMID 32358836›Full record

Trial reportTransfusion2020

Cost-effectiveness evaluation of the PROPPR trial transfusion protocols.

Rachael A Callcut, Kit N Simpson, Sarah Baraniuk, Erin E Fox, Barbara C Tilley, John B Holcomb, PROPPR Study Group

Abstract readClinical Trial, Phase IIIMulticenter StudyPragmatic Clinical Trial
In one paragraph

Trial report in Transfusion, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Blood transfusion strategies for major bleeding in trauma.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rachael A CallcutDivision of General Surgery, Department of Surgery, School of Medicine, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0002-1582-6716
Kit N SimpsonDepartment of Healthcare Leadership & Management, Medical University of South Carolina, Charleston, South Carolina, USA.
Sarah BaraniukDivision of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Erin E FoxCenter for Translational Injury Research and Department of Surgery, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Barbara C TilleyDivision of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.
John B HolcombDivision of Acute Care Surgery, Department of Surgery, Center for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama, USA.
PROPPR Study Group

Funding

Resuscitation Outcomes Consortium (ROC) Data Coordinating CenterU01HL077863 · NHLBI · UNIVERSITY OF WASHINGTON · PI MAY, SUSANNE · 2004 to 2015
$125.1M
R01 Administrative Supplement for AI Prediction of Trauma Resuscitation ResponsivenessR01HL149670 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CALLCUT, RACHAEL A · 2020 to 2024
$4.6M
Advancing Outcome Metrics in Trauma Surgery Through Utilization of Big DataK01ES026834 · NIEHS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CALLCUT, RACHAEL A · 2015 to 2018
$889k
NHLBI NIH HHS R01 HL149670NHLBI NIH HHS U01 HL077863NHLBI NIH HHS U01HL077863NIEHS NIH HHS K01 ES026834NIEHS NIH HHS K01ES026834
6 · The paper itself

Abstract

backgroundThere have been no prior investigations of the cost effectiveness of transfusion strategies for trauma resuscitation. The Pragmatic, Randomized, Optimal Platelet and Plasma Ratios (PROPPR) study was a Phase III multisite, randomized trial in 680 subjects comparing the efficacy of 1:1:1 transfusion ratios of plasma and platelets to red blood cells with the 1:1:2 ratio. We hypothesized that 1:1:1 transfusion results in an acceptable incremental cost-effectiveness ratio, when estimated using patients' age-specific life expectancy and cost of care during the 30-day PROPPR trial period. STUDY DESIGN AND

methodsInternational Classification of Diseases, Ninth Revision codes were prospectively collected, and subjects were matched 1:2 to subjects in the Healthcare Utilization Program State Inpatient Data to estimate cost weights. We used a decision tree analysis, combined with standard costs and estimated years of expected survival to determine the cost effectiveness of the two treatments.

resultsThe 1:1:1 group had higher overall costs for the blood products but were more likely to achieve hemostasis and decreased hemorrhagic death by 24 hours (p = 0.006). For every 100 patients treated in the 1:1:1 group, eight more achieved hemostasis than in the 1:1:2 group. At 30 days, the total hospital cost per 100 patients was $5.6 million in the 1:1:1 group compared with $5.0 million in the 1:1:2 group. For each 100 patients, the 1:1:1 group had 218.5 more years of life expectancy. This was at a cost of $2994 per year gained.

conclusionThe 1:1:1 transfusion ratio in severely injured hemorrhaging trauma patients is a very cost-effective strategy for increasing hemostasis and decreasing trauma deaths.

Indexed as

AdolescentAdultBlood Cell CountBlood PlateletsBlood TransfusionCost-Benefit AnalysisErythrocyte CountErythrocytesErythrocyte TransfusionFemaleHemorrhageHospital MortalityHumansLength of StayMaleMiddle Aged

Identifiers

PMID32358836
PMCPMC7567498

What OpenQuestion holds

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Registered trials

None linked

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.