For patients presenting with severe hemorrhage, receipt of whole blood (WB) transfusion earlier within the first 24 hours of emergency department arrival is associated with improved survival, according to a study published online Jan. 31 in JAMA Surgery.

Crisanto M. Torres, M.D., M.P.H., from Boston Medical Center, and colleagues examined whether earlier timing of first WB transfusion is associated with improved survival at 24 hours and 30 days among adult trauma patients presenting with severe hemorrhage in a retrospective cohort study. Profoundly injured patients who received WB as an adjunct to a massive transfusion protocol (MTP; earlier) were compared to patients who had yet to receive WB as part of MTP (later) at any given time point with 24 hours of emergency department arrival; a total of 1,394 patients met the inclusion criteria.

A difference in survival was seen within one hour of emergency department presentation and WB transfusion in the survival curve. The researchers found that at each time point, WB transfusion as an adjunct to MTP given earlier versus later was associated with improved survival at 24 hours (adjusted hazard ratio for mortality, 0.40). The survival benefit for earlier WB transfusion persisted at 30 days (adjusted hazard ratio for mortality, 0.32).

“Early receipt of WB at any time point within the first 24 hours of emergency department arrival was associated with improved survival in patients presenting with severe hemorrhage,” the authors write. “The survival benefit was noted shortly after transfusion.”

One author disclosed ties to the biopharmaceutical industry.

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