Abstract Introduction Trauma remains the leading cause of mortality and morbidity in children in the United States. Given the limited data on current low titer group O whole blood (LTOWB) use in pediatric trauma, this study was performed to describe current practices of LTOWB use among children, focusing on potential sex‐based differences in LTOWB administration. Methods Female children <18 years who received any quantity of any blood product within 4‐h of admission at a center with documented LTOWB use were compared to similarly aged males in the Trauma Quality Improvement Program (TQIP) database from 2020 to 2023. Results From 2020 to 2023, there were 16,482 children who met inclusion criteria: 4885 females and 11,597 males. Among 2136 LTOWB recipients, 79% (1682) were male. Median (IQR) composite injury severity scores were 26 (17–35) among females versus 25 (16–34, p < .001) among males. Females had a higher proportion of collision mechanisms (68% vs. 43%, p < .001) but a lower proportion of firearm mechanisms (19% vs. 44%, p < .001). Overall, after adjusting for differences, males were more likely to receive LTOWB (odds ratio OR 1.07, 1.05–1.08). When stratified by age and adjusted, the odds ratio for males receiving LTOWB were: <4 years (OR 0.88, 0.62–1.25), 5–9 years (1.16, 0.83–1.62), 10–14 years (1.13, 0.89–1.45), and 15–17 years (1.64, 1.40–1.93). Conclusions Use of LTOWB was similar between male and female patients for younger children. However, among children age 15–17 years, males were more likely than females to receive LTOWB. The reasons for these differences among different age groups need to be elucidated further.
Eason et al. (2026) studied this question.