Platelet-to-red blood cell ratio and mortality in bleeding trauma patients: A systematic review and meta-analysis

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Platelet-to-red blood cell ratio and mortality in bleeding trauma patients: A systematic review and meta-analysis. / Kleinveld, Derek J. B.; van Amstel, Rombout B. E.; Wirtz, Mathijs R. et al.

In: Transfusion, Vol. 61, No. S1, 01.07.2021, p. S243-S251.

Research output: Contribution to journal › Article › Academic › peer-review

BibTeX

@article{475121bcb1d143e0840241332d3a03bd,

title = "Platelet-to-red blood cell ratio and mortality in bleeding trauma patients: A systematic review and meta-analysis",

abstract = "Background: In traumatic bleeding, transfusion practice has shifted toward higher doses of platelets and plasma transfusion. The aim of this systematic review was to investigate whether a higher platelet-to-red blood cell (RBC) transfusion ratio improves mortality without worsening organ failure when compared with a lower ratio of platelet-to-RBC. Methods: Pubmed, Medline, and Embase were screened for randomized controlled trials (RCTs) in bleeding trauma patients (age ≥16 years) receiving platelet transfusion between 1946 until October 2020. High platelet:RBC ratio was defined as being the highest ratio within an included study. Primary outcome was 24 hour mortality. Secondary outcomes were 30-day mortality, thromboembolic events, organ failure, and correction of coagulopathy. Results: In total five RCTs (n = 1757 patients) were included. A high platelet:RBC compared with a low platelet:RBC ratio significantly improved 24 hour mortality (odds ratio [OR] 0.69 [0.53–0.89]) and 30- day mortality (OR 0.78 [0.63–0.98]). There was no difference between platelet:RBC ratio groups in thromboembolic events and organ failure. Correction of coagulopathy was reported in five studies, in which platelet dose had no impact on trauma-induced coagulopathy. Conclusions: In traumatic bleeding, a high platelet:RBC improves mortality as compared to low platelet:RBC ratio. The high platelet:RBC ratio does not influence thromboembolic or organ failure event rates.",

keywords = "coagulopathy, organ failure, platelet, transfusion, trauma",

author = "Kleinveld, {Derek J. B.} and {van Amstel}, {Rombout B. E.} and Wirtz, {Mathijs R.} and Geeraedts, {Leo M. G.} and Goslings, {J. Carel} and Hollmann, {Markus W.} and Juffermans, {Nicole P.}",

note = "Funding Information: Dr Hollmann is Executive Section Editor Pharmacology with Anesthesiology and Section Editor Anesthesiology with the Journal of Clinical Medicine. He has received research funding from ZonMW, STW, SCA, ESA, Eurocept BV, Edwards Life Sciences. Dr Hollmann served as consultant for Eurocept BV and ECHO BV and received speakers fees from CSL Behring and BBraun. All other authors have disclosed no conflicts of interest. Publisher Copyright: {\textcopyright} 2021 The Authors. Transfusion published by Wiley Periodicals LLC. on behalf of AABB.",

year = "2021",

month = jul,

day = "1",

doi = "10.1111/trf.16455",

language = "English",

volume = "61",

pages = "S243--S251",

journal = "Transfusion",

issn = "0041-1132",

publisher = "Wiley-Blackwell",

number = "S1",

}

RIS

TY - JOUR

T1 - Platelet-to-red blood cell ratio and mortality in bleeding trauma patients: A systematic review and meta-analysis

AU - Kleinveld, Derek J. B.

AU - van Amstel, Rombout B. E.

AU - Wirtz, Mathijs R.

AU - Geeraedts, Leo M. G.

AU - Goslings, J. Carel

AU - Hollmann, Markus W.

AU - Juffermans, Nicole P.

N1 - Funding Information: Dr Hollmann is Executive Section Editor Pharmacology with Anesthesiology and Section Editor Anesthesiology with the Journal of Clinical Medicine. He has received research funding from ZonMW, STW, SCA, ESA, Eurocept BV, Edwards Life Sciences. Dr Hollmann served as consultant for Eurocept BV and ECHO BV and received speakers fees from CSL Behring and BBraun. All other authors have disclosed no conflicts of interest. Publisher Copyright: © 2021 The Authors. Transfusion published by Wiley Periodicals LLC. on behalf of AABB.

PY - 2021/7/1

Y1 - 2021/7/1

N2 - Background: In traumatic bleeding, transfusion practice has shifted toward higher doses of platelets and plasma transfusion. The aim of this systematic review was to investigate whether a higher platelet-to-red blood cell (RBC) transfusion ratio improves mortality without worsening organ failure when compared with a lower ratio of platelet-to-RBC. Methods: Pubmed, Medline, and Embase were screened for randomized controlled trials (RCTs) in bleeding trauma patients (age ≥16 years) receiving platelet transfusion between 1946 until October 2020. High platelet:RBC ratio was defined as being the highest ratio within an included study. Primary outcome was 24 hour mortality. Secondary outcomes were 30-day mortality, thromboembolic events, organ failure, and correction of coagulopathy. Results: In total five RCTs (n = 1757 patients) were included. A high platelet:RBC compared with a low platelet:RBC ratio significantly improved 24 hour mortality (odds ratio [OR] 0.69 [0.53–0.89]) and 30- day mortality (OR 0.78 [0.63–0.98]). There was no difference between platelet:RBC ratio groups in thromboembolic events and organ failure. Correction of coagulopathy was reported in five studies, in which platelet dose had no impact on trauma-induced coagulopathy. Conclusions: In traumatic bleeding, a high platelet:RBC improves mortality as compared to low platelet:RBC ratio. The high platelet:RBC ratio does not influence thromboembolic or organ failure event rates.

AB - Background: In traumatic bleeding, transfusion practice has shifted toward higher doses of platelets and plasma transfusion. The aim of this systematic review was to investigate whether a higher platelet-to-red blood cell (RBC) transfusion ratio improves mortality without worsening organ failure when compared with a lower ratio of platelet-to-RBC. Methods: Pubmed, Medline, and Embase were screened for randomized controlled trials (RCTs) in bleeding trauma patients (age ≥16 years) receiving platelet transfusion between 1946 until October 2020. High platelet:RBC ratio was defined as being the highest ratio within an included study. Primary outcome was 24 hour mortality. Secondary outcomes were 30-day mortality, thromboembolic events, organ failure, and correction of coagulopathy. Results: In total five RCTs (n = 1757 patients) were included. A high platelet:RBC compared with a low platelet:RBC ratio significantly improved 24 hour mortality (odds ratio [OR] 0.69 [0.53–0.89]) and 30- day mortality (OR 0.78 [0.63–0.98]). There was no difference between platelet:RBC ratio groups in thromboembolic events and organ failure. Correction of coagulopathy was reported in five studies, in which platelet dose had no impact on trauma-induced coagulopathy. Conclusions: In traumatic bleeding, a high platelet:RBC improves mortality as compared to low platelet:RBC ratio. The high platelet:RBC ratio does not influence thromboembolic or organ failure event rates.

KW - coagulopathy

KW - organ failure

KW - platelet

KW - transfusion

KW - trauma

UR - http://www.scopus.com/inward/record.url?scp=85110290418&partnerID=8YFLogxK

U2 - 10.1111/trf.16455

DO - 10.1111/trf.16455

M3 - Article

C2 - 34269443

VL - 61

SP - S243-S251

JO - Transfusion

JF - Transfusion

SN - 0041-1132

IS - S1

ER -

ID: 19262329

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