ArticleTransfusion2025
Sex-based disparities in low-titer O whole blood utilization and mortality among severely injured trauma patients.
Article in Transfusion, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- A stochastic, physiology-based digital twin model of hemostasis and oxygenation in trauma resuscitation.Research square · 2026Article
- The THOR network best practices for females of childbearing potential with life-threatening hemorrhage: Guidance for emergency medical services and hospitals.Transfusion · 2026Review
- Prehospital Blood Transfusion Coalition: framework for EMS Blood Program Coordinator responsibilities.Trauma surgery & acute care open · 2026Article
- From Battlefield to Blood Bank: Leveraging the Whole Blood Resurgence to Advance Global Health Equity.World journal of surgery · 2025Article
- Sex-based disparities in low-titer O whole blood utilization and mortality among severely injured trauma patients.Transfusion · 2025Article
- Prehospital blood transfusion coalition clinical practice guideline for civilian emergency medical services.Trauma surgery & acute care open · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow-titer O whole blood (LTOWB) is commonly used in the United States for severe bleeding. Our objective was to examine disparities in LTOWB utilization and its association with survival. STUDY DESIGN AND
methodsThis retrospective analysis included patients receiving at least 1 L of red blood cells (RBC) or LTOWB in the first 4 h of admission. Analyses were stratified by sex and age (<50 years "younger" and ≥50 years "older"). Adjusted analyses for the receipt of LTOWB and 24-h mortality were performed. Causal mediation analysis assessed whether the ratio of LTOWB to total transfused volume mediated associations with mortality.
resultsThe younger cohort included 21,192 females and 75,517 males, and the older cohort included 19,761 females and 40,924 males. Upon adjusted analyses, younger and older females were less likely to receive LTOWB OR (95% confidence interval [CI]), 0.61 (0.58-0.64) and OR 0.83 (0.76-0.87), respectively. Increased ratio of LTOWB to total transfused volume was independently associated with reduced mortality in males and females in both young and older cohorts, OR 0.81 (0.74-0.89) and OR 0.74 (0.66-0.83), respectively. Older females had an increased risk of mortality compared with males, OR 1.18 (1.09-1.28). Causal mediation analysis indicated a negligible influence of LTOWB:TTV ratio on the associations between patient sex and mortality (0.11% younger; 0.02% older cohorts).
conclusionSignificant sex-based disparities exist in LTOWB utilization among severely injured trauma patients. Higher LTOWB ratios are associated with reduced mortality in both females and males. Females above 50 are at increased risk of mortality unrelated to the LTOWB ratio administered.
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