The survival impact of plasma to red blood cell ratio in massively transfused non-trauma patients

P. G. Teixeira, K. Inaba, E. Karamanos, P. Rhee, I. Shulman, D. Skiada, K. Chouliaras, D. Demetriades

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Purpose: High ratios of Plasma to Packed Red Blood Cells (FFP:PRBC) improve survival in massively transfused trauma patients. We hypothesized that non-trauma patients also benefit from this transfusion strategy. Methods: Non-trauma patients requiring massive transfusion from November 2003 to September 2011 were reviewed. Logistic regression was performed to identify independent predictors of mortality. The population was stratified using two FFP:PRBC ratio cut-offs (1:2 and 1:3) and adjusted mortality derived. Results: Over 8 years, 29 % (260/908) of massively transfused surgical patients were non-trauma patients. Mortality decreased with increasing FFP:PRBC ratios (45 % for ratio ≤1:8, 33 % for ratio >1:8 and ≤1:3, 27 % for ratio >1:3 and ≤1:2 and 25 % for ratio >1:2). Increasing FFP:PRBC ratio independently predicted survival (AOR [95 % CI]: 1.91 [1.35–2.71]; p < 0.001). Patients achieving a ratio >1:3 had improved survival (AOR [95 % CI]: 3.24 [1.24–8.47]; p = 0.016). Conclusion: In non-trauma patients undergoing massive transfusion, increasing FFP:PRBC ratio was associated with improved survival. A ratio >1:3 significantly improved survival probability.

Original languageEnglish (US)
Pages (from-to)393-398
Number of pages6
JournalEuropean Journal of Trauma and Emergency Surgery
Issue number3
StatePublished - Jun 1 2017


  • Blood components ratio
  • Emergency surgery
  • Massive transfusion
  • Plasma

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Orthopedics and Sports Medicine
  • Critical Care and Intensive Care Medicine


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