Evidence mapPaperPMID 40186381Full record

ArticleTransfusion2025

Nationwide trends in prehospital blood product use after injury 2020-2023.

Christine Carico, Chandler Annesi, N Clay Mann, Matthew J Levy, Pawan Acharya, Timothy Hurson, Daniel Lammers, Jan O Jansen, Jeffrey D Kerby, John B Holcomb and 1 more

Abstract read
In one paragraph

Article in Transfusion, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
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

9 citing papers in PubMed.

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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

11 authors.

Christine CaricoCenter for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID https://orcid.org/0000-0001-7426-8200
Chandler AnnesiCenter for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID https://orcid.org/0000-0002-6361-9842
N Clay MannDepartment of Pediatrics, University of Utah School of Medicine, University of Utah, Salt Lake City, Utah, USA.
Matthew J LevyDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Pawan AcharyaCenter for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Timothy HursonCenter for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID https://orcid.org/0009-0007-5614-183X
Daniel LammersDepartment of General Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0002-9489-3633
Jan O JansenCenter for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID https://orcid.org/0000-0001-8863-4398
Jeffrey D KerbyCenter for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama, USA.
John B HolcombCenter for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID https://orcid.org/0000-0001-8312-9157
Zain G HashmiCenter for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID https://orcid.org/0000-0002-5867-0272

Funding

CSL BehringInfrascanNational Institute for Health and Care ResearchNIH HHSPrytime MedicalRevMedXU.S. Department of Defense
6 · The paper itself

Abstract

introductionPrehospital blood transfusion improves survival after injury. Understanding potential demand for and usage of prehospital blood transfusion is important to help improve supply and utilization of this prehospital intervention. The primary objective of this study is to describe potential current demand for prehospital blood product in adults after blunt and penetrating injury from 2020 to 2023. We also estimate the extent to which this potential demand is being met.

methodsPatients ≥16 years with blunt/penetrating injuries included in the National Emergency Medical Services Information System (NEMSIS) from 2020 to 2023 were identified. Patients were classified into Cohort 1 (systolic blood pressure (SBP) <90 and heart rate (HR) >108 or SBP <70) and Cohort 2 (shock index ≥1), and total numbers in each cohort were reported. Additionally, the number and percentage of patients who were potentially eligible for and who received prehospital blood transfusion were calculated and trended over time.

resultsAfter exclusions, 20.4 million trauma patients were included. A total of 262,761 Cohort 1 patients and 1,227,556 Cohort 2 patients were potentially eligible for transfusion. Estimated demand for blood transfusion increased from 2020 to 2023 (p < 0.001) in both cohorts. Cohort 1 had the highest estimated proportion of patients (0.9%, n = 2,289) who received transfusion, demonstrating that few potentially eligible adult trauma patients received blood product.

conclusionsAltogether, 1.2 million hemodynamically unstable trauma patients were potentially eligible for prehospital blood transfusion after injury during 2020-2023, yet less than 1% received this intervention. These data underscore the need to evaluate and resolve barriers to wider use of prehospital blood transfusions.

Indexed as

Blood TransfusionEmergency Medical ServicesWounds and InjuriesWounds, NonpenetratingWounds, PenetratingAdolescentAdultFemaleHumansMaleMiddle AgedUnited StatesYoung Adultblood managementtransfusion practices (surgical)

Identifiers

PMID40186381
PMCPMC12035996

What Socratic holds

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LicenceCC BY
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Registered trials

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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 Socratic graph.