Date of Award

2023

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

Objective: The objective of this selective EBM review is to determine whether administration of prehospital plasma will improve survival rates in injured adults at risk for hemorrhagic shock.

Study Design: A systematic review of two randomized controlled trials (RCT) and one retrospective cohort study

Data Sources: All three studies were identified using PubMed and selected based on their ability to answer the clinical question while including patient-oriented outcomes (POEMs). All articles were peer-reviewed, published in English, and published on or after 2011.

Outcomes Measured: The outcomes addressed were survival rates, calculated using mortality rates based on if the patient was alive or not at the time of follow up. This includes 30-day, 28-day, and in-hospital mortality rates.

Results: An RCT by Sperry et al. showed improved survival rates of 75.9% in those who received plasma versus 65.9% in those who received standard care (p=0.03). Moore et al. showed a survival rate of 90% in the control group versus 85% in those who received fresh-frozen plasma (p=0.37). Shalifer et al. looked at freeze-dried plasma and found that 91.5% of patients who received it survived versus 93.8% who did not (p=0.17).

Conclusion: Evidence between all three studies was conflicting. Future studies should investigate further the forms of plasma for maximum benefit and logistic ease.

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