Trends in massive transfusion practice for trauma in Japan from 2011 to 2020: a nationwide inpatient database study

Ohbe, Hiroyuki; Tagami, Takashi; Endo, Akira; Miyata, Shigeki; Matsui, Hiroki; Fushimi, Kiyohide; Kushimoto, Shigeki; Yasunaga, Hideo

doi:10.1186/s40560-023-00685-0

Journal of Intensive Care

Table 1 Trends in the incidence and blood product consumption for trauma requiring massive transfusion

From: Trends in massive transfusion practice for trauma in Japan from 2011 to 2020: a nationwide inpatient database study

	Formula	Total	Calendar year										P for
	Formula	Total	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	trend
Number of hospitals, n	–	1811	1114	1185	1187	1273	1353	1387	1331	1318	1229	1211	–
Hospitalizations for trauma, n	A	3,530,846	226,202	309,254	326,474	363,141	379,347	405,447	404,825	393,090	369,497	353,569	0.089
In a tertiary emergency hospital	B	1,225,865	83,687	108,442	118,070	127,429	129,635	136,136	137,943	134,157	130,102	120,264	0.040
With at least one unit of RBCs	C	182,242	12,140	15,459	15,875	17,890	19,330	20,749	20,847	20,167	19,769	20,016	0.010
With ≥ 10 units of RBCs	D	17,859	1662	1788	1913	1969	1871	1971	1855	1743	1651	1436	0.24
With ≥ 20 units of RBCs	E	5247	532	524	585	594	571	586	517	501	473	364	0.040
Number of hospitals performing MT, n	–	486	188	213	211	210	203	214	204	197	182	161	–
Hospital volume of MT, median (IQR)	–	2 (1,3)	2 (1,3)	2 (1,3)	2 (1,3)	2 (1,3)	2 (1,4)	2 (1,3)	2 (1,3)	2 (1,3)	2 (1,3)	2 (1,3)	–
Incidence of MT, %*
Denominator
All trauma	E/A	0.15	0.24	0.17	0.18	0.16	0.15	0.14	0.13	0.13	0.13	0.10	< 0.001
In a tertiary emergency hospital	E/B	0.43	0.64	0.48	0.50	0.47	0.44	0.43	0.37	0.37	0.36	0.30	< 0.001
Requiring at least one unit of RBCs	E/C	2.88	4.38	3.39	3.69	3.32	2.95	2.82	2.48	2.48	2.39	1.82	< 0.001
Consumption of blood product^†, unit
For all trauma patients
RBC	F	2,481,513	177,676	225,663	230,852	254,098	267,562	279,670	277,609	265,882	254,770	247,733	0.13
FFP	G	713,513	52,486	66,888	71,158	71,241	75,611	78,117	79,282	77,552	74,512	66,666	0.13
Platelets	H	904,451	64,491	85,824	92,324	98,878	100,032	99,736	99,205	94,071	91,106	78,784	0.79
For trauma requiring MT
RBC	I	205,134	20,538	19,941	22,228	22,458	22,551	22,919	21,063	19,892	19,201	14,343	0.25
FFP	J	185,281	16,490	16,156	18,703	19,203	20,801	21,180	19,614	19,321	19,366	14,447	0.42
Platelets	K	173,250	14,674	15,660	18,589	18,956	20,000	20,118	19,125	16,897	17,296	11,935	0.79
Consumption rate for MT^‡, %
RBC	I/F	8.3	11.6	8.8	9.6	8.8	8.4	8.2	7.6	7.5	7.5	5.8	< 0.001
FFP	J/G	26.0	31.4	24.2	26.3	27.0	27.5	27.1	24.7	24.9	26.0	21.7	0.18
Platelets	K/H	19.2	22.8	18.2	20.1	19.2	20.0	20.2	19.3	18.0	19.0	15.1	0.060

RBC: red blood cell; MT: massive transfusion; IQR: interquartile range; FFP: fresh frozen plasma
*While calculating the incidence of massive transfusion, the numerator was the total number of hospitalizations for trauma requiring massive transfusion defined as the administration of at least 20 units of red blood cells within the first two days of admission and the denominator was the total number of hospitalizations for all trauma, trauma in a tertiary emergency hospital, or trauma requiring at least one unit of RBCs
^†The consumption of blood products was calculated using the sum of those used during hospitalization
^‡While calculating the consumption rate for massive transfusion, the numerator was the total number of blood products administered for patients with trauma requiring massive transfusion; and the denominator was the total number of blood products administered to all patients with trauma

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ISSN: 2052-0492

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