The prospective, observational, multicenter, major trauma transfusion (PROMMTT) study: Comparative effectiveness of a time-varying treatment with competing risks
John B. Holcomb,Deborah J. del Junco,Erin E. Fox,Charles E. Wade,Mitchell J. Cohen,Martin A. Schreiber,Louis H. Alarcon,Yu Bai,Karen J. Brasel,Eileen M. Bulger,Bryan A. Cotton,Nena Matijevic,Peter Muskat,John G. Myers,Herb A. Phelan,Christopher E. White,Jiajie Zhang,Mohammad H. Rahbar +17 more
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TLDR
Higher plasma and platelet ratios early in resuscitation were associated with decreased mortality in patients who received transfusions of at least 3 units of blood products during the first 24 hours after admission, and among survivors at 24 hours, the subsequent risk of death by day 30 was not associated with plasma or Platelet ratios.Abstract:
Objective To relate in-hospital mortality to early transfusion of plasma and/or platelets and to time-varying plasma:red blood cell (RBC) and platelet:RBC ratios. Design Prospective cohort study documenting the timing of transfusions during active resuscitation and patient outcomes. Data were analyzed using time-dependent proportional hazards models. Setting Ten US level I trauma centers. Patients Adult trauma patients surviving for 30 minutes after admission who received a transfusion of at least 1 unit of RBCs within 6 hours of admission (n = 1245, the original study group) and at least 3 total units (of RBCs, plasma, or platelets) within 24 hours (n = 905, the analysis group). Main Outcome Measure In-hospital mortality. Results Plasma:RBC and platelet:RBC ratios were not constant during the first 24 hours (P Conclusions Higher plasma and platelet ratios early in resuscitation were associated with decreased mortality in patients who received transfusions of at least 3 units of blood products during the first 24 hours after admission. Among survivors at 24 hours, the subsequent risk of death by day 30 was not associated with plasma or platelet ratios.read more
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Prehospital shock index and pulse pressure/heart rate ratio to predict massive transfusion after severe trauma: Retrospective analysis of a large regional trauma database.
Julien Pottecher,François-Xavier Ageron,Clémence Fauché,Denis Chemla,Eric Noll,Jacques Duranteau,Laurent Chapiteau,Jean François Payen,Pierre Bouzat +8 more
TL;DR: In an unselected trauma population, prehospital SI and PP/HR ratio were moderately accurate in predicting subsequent MT, and in the seemingly least severe patients, an improvement of prehospital undertriage for MT may be gained by using the PP/ HR ratio.
Journal ArticleDOI
Resuscitative Strategies to Modulate the Endotheliopathy of Trauma: From Cell to Patient.
TL;DR: Clinical studies using fibrinogen and cyroprecipitate to aid in hemostasis of the bleeding patient are reviewed and new data to suggest a role for plasma and its byproducts to treat the dysfunctional endothelium associated with nonbleeding diseases is presented.
Journal ArticleDOI
Not only in trauma patients: hospital-wide implementation of a massive transfusion protocol†
L. M. Baumann Kreuziger,Colleen T. Morton,A. T. Subramanian,Christopher P. Anderson,David J. Dries +4 more
TL;DR: To review outcomes of massive transfusion protocol (MTP) activation and determine the impact of MTP implementation on blood bank use, a large number of patients with history of blood transfusion need to be referred for treatment.
Journal ArticleDOI
Targeted Coagulation Management in Severe Trauma: The Controversies and the Evidence
James Winearls,Michael C. Reade,Helen Miles,Andrew C. Bulmer,Don Campbell,Klaus Görlinger,John F. Fraser +6 more
TL;DR: The use of VHA to quantify the functional contributions of individual components of the coagulation system may permit targeted treatment of TIC but remains controversial and is unlikely to demonstrate a mortality benefit in light of the heterogeneity of the trauma population.
Journal ArticleDOI
Military-to-civilian translation of battlefield innovations in operative trauma care
Adil H. Haider,Lydia C. Piper,Cheryl K. Zogg,Eric B. Schneider,Jean A. Orman,Frank K Butler,Robert T. Gerhardt,Elliott R. Haut,Jacques Mather,Ellen J. MacKenzie,Diane A. Schwartz,David W. Geyer,Joseph J. DuBose,Todd E. Rasmussen,Lorne H. Blackbourne +14 more
TL;DR: This national survey of TMDs suggests that military data supporting DCR has altered civilian practice, and civilian academic efforts are needed to further research and enhance understandings that foster improved trauma surgeon awareness of military-to-civilian translation.
References
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The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies
Erik von Elm,Douglas G. Altman,Matthias Egger,Matthias Egger,Stuart J. Pocock,Peter C Gøtzsche,Jan P. Vandenbroucke +6 more
TL;DR: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study, resulting in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.
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The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies
Erik von Elm,Douglas G. Altman,Matthias Egger,Matthias Egger,Stuart J. Pocock,Peter C Gøtzsche,Jan P. Vandenbroucke +6 more
TL;DR: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study, resulting in a checklist of 22 items that relate to the title, abstract, introduction, methods, results, and discussion sections of articles.
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The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies
E von Elm,Douglas G. Altman,Matthias Egger,Matthias Egger,Stuart J. Pocock,Peter C Gøtzsche,Jan P. Vandenbroucke +6 more
TL;DR: The STROBE Statement is a checklist of items that should be addressed in articles reporting on the 3 main study designs of analytical epidemiology: cohort, casecontrol, and cross-sectional studies; these recommendations are not prescriptions for designing or conducting studies.
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Applied Survival Analysis: Regression Modeling of Time-to-Event Data
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