BACKGROUND: The combined effects of balanced transfusion ratios and use of procoagulant and antifibrinolytic therapies on @entity130 -induced exsanguination are not known. The aim of this study was to investigate the combined effect of transfusion ratios, @entity927 and products containing @entity2002 on the outcome of injured @entity1 with @entity548 . METHODS: A prospective multicentre observational study was performed in six level 1 @entity130 centres. Injured @entity1 who received at least 4   units of red blood cells (RBCs) were analysed and divided into groups receiving a low (less than 1   :   1) or high (1 or more   :   1) ratio of plasma or platelets to RBCs, and in receipt or not of @entity927 or @entity2002 products ( @entity2002 concentrates or cryoprecipitate). @entity2357 models were used to assess the effect of transfusion strategies on the outcomes 'alive and free from massive transfusion' (at least 10   units of RBCs in 24   h) and early 'normalization of @entity1003 ' (defined as an international normalized ratio of 1  2 or less). RESULTS: A total of 385 injured @entity1 with ongoing @entity548 were included in the study. Strategies that were independently associated with an increased number of @entity1 alive and without massive transfusion were a high platelet to RBC ratio (odds ratio (OR) 2  67, 95 per cent c.i. 1  24 to 5  77; P   =   0  012), a high plasma to RBC ratio (OR 2  07, 1  03 to 4  13; P   =   0  040) and treatment with @entity927 (OR 2  71, 1  29 to 5  71; P   =   0  009). No strategies were associated with correction of @entity1003 . CONCLUSION: A high platelet or plasma to RBC ratio, and use of @entity927 were associated with a decreased need for massive transfusion and increased survival in injured @entity1 with @entity548 . Early normalization of @entity1003 was not seen for any transfusion ratio, or for use of @entity927 or @entity2002 products.

Combined effect of therapeutic strategies for @entity548 on early survival, transfusion needs and correction of XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2002 :: ('2244', 'Gene') :: ['fibrinogen'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity1003 :: ('MESH:D001778', 'Disease') :: ['coagulopathy'] @entity2357 :: ('MESH:C537770', 'Disease') :: ['Logistic regression'] @entity927 :: ('MESH:D014148', 'Chemical') :: ['tranexamic acid'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity1003 :: (MESH:D001778,Disease) :: ['coagulopathy']
