Patients with trauma and hemorrhagic shock (n=626).
Plasma group: prehospital transfusion of 2 U of thawed plasma followed by standard care in the prehospital environment, (n=297).
Standard care group: crystalloid-based resuscitation, (n=329).
A Cox regression analysis showed a significant overall survival benefit for plasma (hazard ratio [HR], 0.65) after adjustment for injury severity, age, and clinical trial cohort (COMBAT or PAMPer). A significant association with prehospital transport time was detected (from arrival on scene to arrival at the trauma center). Increased mortality was observed in patients in the standard care group when prehospital transport was longer than 20 minutes (HR, 2.12), while increased mortality was not observed in patients in the prehospital plasma group (HR, 0.78). No serious adverse events were associated with prehospital plasma transfusion.