Langan and colleagues completed a review of the Joint Theater Trauma Registry (2002-2011, n=57,179) of US forward combat hospitals, comparing two time periods (pre-2006, prior to damage control resuscitation policies & 2006 to 2011, after DCR implementation), and found

  1. hospital mortality was 4.5% (n=2,565)
    • 74% were severely injured (ISS > 15)
    • 80% died within 24 hours of admission
  2. comparing pre and post DCR periods
    • mean 24-hour volumes of
      • crystalloid decreased (6.1 to 3.2 L, p<0.05)
      • fresh frozen plasma increased (3.2 to 10.1 U, p < 0.05)
    • packed red blood cells to fresh frozen plasma ratio decreased
      • 2.6:1 to 1.4:1 (p < 0.01)
    • mean ISS increased ( 23 to 27; p < 0.05)
      • with more severe head trauma in the DCR cohort