Article Figures & Data
- Figure 1
Principal cohort. HEMS, helicopter emergency services; PAMPer, Prehospital Air Medical Plasma; T0, time 0.
- Figure 2
Kaplan-Meier survival analysis for the primary cohort (panel A; n=501) and subgroup (panel B; n=127).
- Figure 3
Adjusted T0 markers for subgroup (Injury Severity Score >30; n=56). Mean adjusted marker values estimated using linear regression controlling for Injury Severity Score, hospital admission Injury Severity Score, presence of a systolic blood pressure <70 mm Hg, international ratio, and transfusions with error bars representing the SD and statistically significant co-efficient p values. Units for all interleukins, TNF-α, MCP-1, MIG, and GM-CSF are in pg/mL, except IL-23, which is in ng/mL. All cell death marker units are in ng/mL, except VEGF which is in pg/mL. DNA (histone-complexed) is reported as relative units. GM-CSF, granulocyte-macrophage colony-stimulating factor; hcDNA, histone-complexed DNA; IL, interleukin; MCP-1, monocyte chemoattractant protein; MIG, INF-gamma; s100a, human S100 calcium-binding protein A10; suPAR, soluble urokinase receptor; TM, thrombomodulin; TNF-α, tumor necrosing factor-α; VEGF, vascular endothelial growth factor.
- Table 1
Patient and injury characteristics—principal analysis cohort (n=501)
Variable Plasma group P value YOUNG OLD Demographics n=93 n=137 Age, years, mean (SD) 45.7 (17.7) 45.3 (17.2) 0.84 Male gender, No. (%) 65 (70) 99 (72) 0.70 Race, No. (%) 0.21 White 88 (95) 119 (87) Black 4 (4) 10 (7) Other 0 (0) 0 (0) Unknown 0 (0) 2 (1) Hispanic, No. (%) 2 (2.3) 4 (3.1) 0.71 Current smoking, No. (%) 41 (54) 42 (41) 0.09 Body mass index, mean (SD) 30.7 (9.5) 30.0 (6.5) 0.58 Prehospital and injury Penetrating injury, No. (%) 20 (22) 26 (19) 0.64 Injury severity score, median (IQR) 22.0 (13.0, 34.0) 22.0 (16.0, 29.0) 0.59 Traumatic brain injury, No. (%) 17 (36.2) 19 (34.5) 0.86 Hospital transfer, No. (%) 22 (23.7) 30 (22.1) 0.78 Prehospital interval, median (IQR) 3 (3.2) 4 (2.9) 0.89 Hospital Admission heart rate, mean (SD) 105.2 (31.7) 101.9 (28.9) 0.41 Admission systolic blood pressure, mean (SD) 100.7 (39.2) 100.7 (40.8) 1.00 Admission INR, median (IQR) 1.2 (1.1, 1.4) 1.2 (1.1, 1.3) 0.58 Admission hemoglobin, median (IQR) 10.9 (9.0, 13.3) 10.8 (9.4, 12.7) 0.88 Admission rapid thromboelastography Lysis at 30 min, %, median (IQR) 0.1 (0.0, 1.4) 0.2 (0.0, 1.1) 0.75 Max amplitude, min, median (IQR) 59.6 (52.0, 63.5) 56.4 (47.8, 64.7) 0.48 Alpha angle, degrees, median (IQR) 70.8 (62.3, 74.9) 70.2 (61.6, 74.7) 0.60 K-time, min, median (IQR) 1.8 (1.2, 2.7) 1.8 (1.2, 3.0) 0.95 Activated clotting time, median (IQR) 113.0 (97.0, 136.0) 113.0 (105.0, 136.0) 0.46 PRBC in 24 hours, median (IQR) 3.0 (2.0, 6.0) 2.0 (0.0, 7.0) 0.35 Plasma in 24 hours, median (IQR) 0.0 (0.0, 3.0) 0.0 (0.0, 3.0) 0.90 Platelets in 24 hours, median (IQR) 0.0 (0.0, 1.0) 0.0 (0.0, 1.0) 0.63 Crystalloid in 24 hours, median (IQR) 4434 (2372, 6200) 4375 (2200, 6600) 0.96 Multisystem organ failure, No. (%) 61 (65.6) 84 (61.3) 0.51 No., number; PRBC, packed red blood cells.
- Table 2
Model estimation coefficients for markers at T0—YOUNG vs OLD plasma age
Plasma group (n=137) ISS >30 plasma subgroup (n=56) Marker Coefficient 95% CI P value Coefficient 95% CI P value Lower limit Upper limit Lower limit Upper limit IL-1b 0.456 −2.762 3.673 0.781 4.394 1.027 7.761 0.011 IL-2 0.064 −1.791 1.919 0.946 2.414 0.262 4.565 0.028 IL-4 −20.063 −66.499 26.373 0.397 39.6 13.482 65.718 0.003 IL-5 −2.664 −8.369 3.041 0.36 2.667 0.921 4.413 0.003 IL-6 35.696 −158.755 230.147 0.719 7.664 −384.257 399.586 0.969 IL-7 4.116 −2.281 10.513 0.207 11.494 −0.96 23.947 0.07 IL-8 6.21 −11.606 24.026 0.494 −28.604 −86.985 29.776 0.337 IL-9 2.725 −18.023 23.473 0.797 25.238 2.171 48.304 0.032 IL-10 60.645 −102.332 223.622 0.466 −19.358 −285.774 247.058 0.887 IL-17a 1.457 −3.876 6.79 0.592 6.27 0.1 12.439 0.046 IL-17e 69.021 −38.997 177.039 0.21 308.579 103.895 513.264 0.003 IL-21 9.08 −22.34 40.5 0.571 47.905 11.959 83.852 0.009 IL-22 104.23 −248.61 457.071 0.563 715.174 165.919 1264.429 0.011 IL-23 1.042 −6.305 8.39 0.781 12.725 5.139 20.311 0.001 IL-27 51.292 −453.426 556.009 0.842 977.828 137.887 1817.769 0.023 IL-33 10.925 −39.263 61.112 0.67 95.05 32.919 157.18 0.003 GM-CSF −7.832 −20.563 4.9 0.228 14.629 5.478 23.78 0.002 MCP-1 366.455 −29.438 762.349 0.07 −28.592 −912.995 855.811 0.949 MIG 4285.834 −3033.508 11 605.176 0.251 14 107.398 −9169.341 37 384.137 0.235 TNF-α 0.964 −11.013 12.94 0.875 5.174 −28.073 38.421 0.76 Adiponectin −1736.773 −3848.6 375.055 0.107 −355.837 −2733.742 2022.067 0.769 hcDNA −8.264 −18.546 2.017 0.115 −34.837 −49.677 −19.998 0 S100A10 −0.717 −2.027 0.593 0.284 −0.892 −2.003 0.218 0.115 suPAR −0.374 −0.924 0.177 0.183 0.351 −0.64 1.343 0.487 Syndecan-1 2.035 −23.878 27.949 0.878 −54.767 −96.663 −12.872 0.01 TM 0.103 −1.204 1.41 0.877 0.92 −1.079 2.919 0.367 VEGF 81.405 −103.409 266.218 0.388 2.333 −276.162 280.829 0.987 GM-CSF, granulocyte-macrophage colony-stimulating factor; hcDNA, histone-complexed DNA; IL, interleukin; ISS, Injury Severity Score; MCP-1, monocyte chemoattractant protein; MIG, INF-gamma; S100A10, human S100 calcium-binding protein A10; suPAR, soluble urokinase receptor; TM, thrombomodulin; TNF-α, tumor necrosing factor-α; VEGF, vascular endothelial growth factor.
- Table 3
Patient and injury characteristics—subgroup (Injury Severity Score >30, n=127)
Variable Plasma group P value YOUNG OLD Demographics n=30 n=34 Age, years, mean (SD) 40.0 (14.8) 41.9 (19.4) 0.65 Male gender, No. (%) 18 (60) 23 (68) 0.52 Race, No. (%) 0.15 White 29 (97) 29 (85) Black 0 (0) 4 (12) Unknown 1 (3) 1 (3) Hispanic, No. (%) 0 (0.0) 0 (0.0) 0.34 Current smoking, No. (%) 13 (59) 13 (54) 0.74 Body mass index, mean (SD) 30.2 (9.8) 29.6 (7.4) 0.84 Prehospital and injury Penetrating injury, No. (%) 4 (13) 3 (9) 0.56 Injury severity score, median (IQR) 43.0 (35.0, 50.0) 41.0 (34.0, 45.0) 0.26 Traumatic brain injury, No. (%) 8 (50.0) 7 (58.3) 0.66 Admission heart rate, mean (SD) 112.5 (29.6) 98.9 (34.1) 0.10 Admission systolic blood pressure, mean (SD)) 91.8 (33.1) 94.3 (51.4) 0.83 Hospital transfer, No. (%) 6 (20.0) 7 (21.2) 0.47 Prehospital interval, median (IQR) 41.5 (32.8, 54.6) 40.4 (32.8, 48.1) 0.48 Hospital Admission INR, median (IQR) 1.2 (1.1, 1.5) 1.2 (1.1, 1.3) 0.72 Admission hemoglobin, median (IQR) 11.2 (10.3, 12.6) 10.2 (8.9, 11.4) 0.084 Admission rapid thromboelastography Lysis at 30 min, %, median (IQR) 0.2 (0.0, 0.9) 0.2 (0.0, 2.5) 0.85 Max amplitude, min, median (IQR) 59.6 (53.0, 61.5) 55.0 (49.1, 60.6) 0.42 Alpha angle, degrees, median (IQR) 70.0 (68.5, 73.9) 68.2 (61.9, 74.2) 0.79 K-time, min, median (IQR) 1.8 (1.4, 1.8) 2.0 (1.5, 2.7) 0.65 Activated clotting time, median (IQR) 117.0 (109.0, 124.5) 113.0 (89.0, 136.0) 0.64 PRBC in 24 hours, median (IQR) 4.0 (2.0, 11.0) 4.5 (2.0, 10.0) 0.90 Plasma in 24 hours, median (IQR) 2.0 (0.0, 4.0) 0.5 (0.0, 4.0) 0.95 Platelets in 24 hours, median (IQR) 0.0 (0.0, 1.0) 0.0 (0.0, 1.0) 0.78 Crystalloid in 24 hours, median (IQR) 5110.0 (3200.0, 6647.0) 4437.5 (1500.0, 7050.0) 0.49 Multisystem organ failure, No. (%) 20 (66.7) 25 (73.5) 0.55 INR, international ratio; No., number; PRBC, packed red blood cells.
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