Department of Blood Transfusion, Xiangya Hospital, Central South University, Changsha, Hunan Province, China Changsha, Hunan, China (People's Republic)
Background/Case Studies: Investigation on the association between fresh frozen plasma (FFP) transfusion and mortality in patients with sepsis-associated coagulopathy (SAC) was limited. The purpose of this study is to explore the effect of FFP transfusion on mortality in SAC patients.
Study
Design/Methods: The Medical Information Mart for Intensive Care-IV database was searched to identify SAC p</span>atients with and without FFP transfusion. Patients in FFP transfusion group were matched with their counterparts in conventional group via propensity score matching (PSM). In the matched cohort, univariate regression analysis was performed to evaluate the association between FFP transfusion and outcomes. Multivariate regression analysis, inverse probability of treatment weighing (IPTW) and covariate adjustment using propensity score (CAPS) were employed to validate our findings. The change trends of indexes during the treatment period were assessed by a generalized additive mixed model.
Results/Findings: A total of 1456 SAC patients were included. After PSM, each group comprised 291 cases. In matched cohort, FFP transfusion was associated with reduced risks of 28-day mortality (hazard ratio [HR]: 0.66, 95% confidence interval [CI]: 0.45-0.97), in-hospital mortality (HR: 0.60, 95% CI: 0.39-0.91), 1-year mortality (HR: 0.72, 95% CI: 0.54-0.96), and overt disseminated intravascular coagulation events (odds ratio [OR]: 0.50, 95% CI: 0.26-0.95). The association between FFP transfusion and reduced 28-day mortality risk remained stable utilizing the method of multivariate regression analysis (HR: 0.68, 95% CI:0.49-0.97), IPTW (HR: 0.69, 95% CI: 0.57-0.84) and CAPS (HR: 0.67, 95% CI: 0.45-0.98). Compared with the conventional group, FFP transfusion group showed decrease in Sequential Organ Failure Assessment (SOFA), international normalized ratio (INR), D-Dimer and lactate, and increase in platelet (PLT). Conclusions: In this non-randomized retrospective study, we observed that FFP transfusion was associated with reduced 28-day mortality in a subset of transfused patients with sepsis-associated coagulopathy. FFP use correlated with a decrease in laboratory measures of DIC.
