Blood transfusion: In the air tonight?.

Background: The use of prehospital blood transfusion (PBT) in air medical transport has become more widespread. However, the effect of PBT remains unknown. The aim of this study was to examine the impact of PBT on 24-hour and overall in-hospital mortality. Methods: This is a retrospective cohort study of all trauma patients carried by air medical transport from the scene to a Level One Trauma Center from 2007 to 2013. We excluded patients who died on the helipad or in the emergency department. Primary outcomes measured were 24-hour and overall in-hospital mortality. Multivariable logistic regressions using all available patient data or the propensity score (for receiving PBT) matched patient data were performed to study the effect of PBT on these outcomes. Results: Of the 5581 patients included in the study, 231 (4%) received PBT. Multivariable regression analyses did not show evidence of PBT effect on 24-hour in-hospital mortality (odds ratio [OR] 1.22; 95% confidence interval [CI] 0.61-2.44), nor on overall in-hospital mortality (OR 1.20; 95% CI 0.55-1.79). Additionally, using 1:1 propensity score matched data, the analysis did not show evidence of PBT effect on 24-hour in-hospital mortality (OR 1.04; 95% CI 0.54-1.98), nor on overall in-hospital mortality (OR 1.05; 95% CI 0.56-1.96). Factors associated with increased 24-hour mortality were advanced age, penetrating injury, increased blood transfusion requirement in the first 24 hours, and decreased Glasgow Coma Scale score (p

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