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Background:

To treat the coagulopathy of trauma, some have suggested early and aggressive use of cryoprecipitate as a source of fibrinogen. Our objective was to determine whether increased ratios of fibrinogen to red blood cells (RBCs) decreased mortality in combat casualties requiring massive transfusion.

Methods:

We performed a retrospective chart review of 252 patients at a US Army combat support hospital who received a massive transfusion (≥ 10 units of RBCs in 24 hours). The typical amount of fibrinogen within each blood product was used to calculate the fibrinogen-to-RBC (F: R) ratio transfused for each patient. Two groups of patients who received either a low (< 0.2 g fibrinogen/RBC Unit) or high (≥ 0.2 g fibrinogen/RBC Unit) F: R ratio were identified. Mortality rates and the cause of death were compared between these groups, and logistic regression was used to determine if the F: R ratio was …