Data Analysis of the Prehospital Trauma Registry: The Joint Trauma System Prehospital Trauma Registry (JTS PHTR) and Department of Defense Trauma Registry (DoDTR)
Over the last century, U.S. military medicine has focused much of its efforts on providing increasingly better care at the point of injury (POI) and transporting patients to military treatment facilities as rapidly as possible. Despite of substantial progress made, 87% of all battlefield deaths in recent U.S. conflicts were reported to occur in the prehospital setting.
Prehospital interventions aimed at hemostatic control (tourniquets, hemostatic dressings, and tranexamic acid) have improved survival, but there is a clear need for enhanced therapeutics at the POI. The use of blood products and damage control resuscitation in combat hospitals have shown an evident benefit. Especially, fresh whole blood (FWB) was proven superior to component therapy as reporting from Afghanistan and Iraq.
In this study, a previously published dataset within the prehospital trauma registry from 2003 through May 2019 was analyzed to evaluate the effect of the prehospital blood use on the survival rate of patients. The data were collected from The Joint Trauma System Prehospital Trauma Registry (JTS PHTR) and Department of Defense Trauma Registry (DoDTR). The JTS PHTR is a data collection and analytic tool designed to provide near-real-time feedback to commanders, which also seeks to reduce morbidity and mortality through performance improvement. The DoDTR is the DoD’s data repository for trauma-related injuries, which includes data on U.S. and non-U.S. military and civilian patients from the POI to final disposition.
The authors of this study identified 1,357 patient encounters in the PHTR from 2013 to 2019. Of these patients, 28 were documented as receiving a a prehospital blood product with a total of 41 administrations. All were battle injuries, and all were wounded in action andseverely injured. However, the majority of patients that received blood products survived to hospital discharge with a high survival rate of 94%.
Since the use of blood products at the POI is critical and shown to improve the survival rate of severely injured patients, extending blood supply lifespan and optimizing logistical chain circulation are required. Click here and find more detailed data on the prehospital blood product administration as well as other prehospital intervention types for severely wounded patients. https://academic.oup.com/milmed/advance-article/doi/10.1093/milmed/usaa563/6046689