ArticleBMJ (Clinical research ed.)2012
Predicting early death in patients with traumatic bleeding: development and validation of prognostic model.
Article in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 4 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Effectiveness and safety of prehospital tranexamic acid in patients with trauma: an updated systematic review and meta-analysis with trial sequential analysis.BMC emergency medicine · 2024Pooled it
- Predictive value of tachycardia for mortality in trauma-related haemorrhagic shock: a systematic review and meta-regression.BMJ open · 2022Pooled it
- Interleukin-6 as a prognostic biomarker of clinical outcomes after traumatic brain injury: a systematic review.Neurosurgical review · 2022Pooled it
- Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients.Lancet (London, England) · 2018Pooled it
- Efficacy and safety of the second in-hospital dose of tranexamic acid after receiving the prehospital dose: double-blind randomized controlled clinical trial in a level 1 trauma center.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Trial
- Effect of tranexamic acid on mortality in patients with traumatic bleeding: prespecified analysis of data from randomised controlled trial.BMJ (Clinical research ed.) · 2012Trial
- Factors Associated With Poor One-Month Glasgow Outcome Scale Scores After Traumatic Brain Injury With Intracranial Hemorrhage in Adult Patients Presenting to the Emergency Department.Emergency medicine international · 2026Article
- Article
- Development and validation of risk prediction model for adverse outcomes in trauma patients.Annals of medicine · 2024Article
- Letter to the Editor: "Obsolescence of nomograms in radiomics research".European radiology · 2024Article
- Reply to Letter to the Editor: "Obsolescence of nomograms in radiomics research".European radiology · 2024Article
- Pre-hospital tranexamic acid administration in patients with a severe hemorrhage: an evaluation after the implementation of tranexamic acid administration in the Dutch pre-hospital protocol.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Why did European Radiology reject my radiomic biomarker paper? How to correctly evaluate imaging biomarkers in a clinical setting.European radiology · 2021Review
- Article
- Efficacy and Safety of Tranexamic Acid in Emergency Trauma: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2021Article
- The Traumatic Brain Injury Model Systems National Database: A Review of Published Research.Neurotrauma reports · 2021Review
- Heart rate variability and pulmonary dysfunction in rats subjected to hemorrhagic shock.BMC cardiovascular disorders · 2020Article
- Prognostic model for traumatic death due to bleeding: cross-sectional international study.BMJ open · 2019Article
- Independent early predictors of mortality in polytrauma patients: a prospective, observational, longitudinal study.Clinics (Sao Paulo, Brazil) · 2017Observational
- Mitochondrial targeting by dichloroacetate improves outcome following hemorrhagic shock.Scientific reports · 2017Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectiveTo develop and validate a prognostic model for early death in patients with traumatic bleeding.
designMultivariable logistic regression of a large international cohort of trauma patients.
setting274 hospitals in 40 high, medium, and low income countries
participantsPrognostic model development: 20,127 trauma patients with, or at risk of, significant bleeding, within 8 hours of injury in the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage (CRASH-2) trial. External validation: 14,220 selected trauma patients from the Trauma Audit and Research Network (TARN), which included mainly patients from the UK. OUTCOMES: In-hospital death within 4 weeks of injury.
results3076 (15%) patients died in the CRASH-2 trial and 1765 (12%) in the TARN dataset. Glasgow coma score, age, and systolic blood pressure were the strongest predictors of mortality. Other predictors included in the final model were geographical region (low, middle, or high income country), heart rate, time since injury, and type of injury. Discrimination and calibration were satisfactory, with C statistics above 0.80 in both CRASH-2 and TARN. A simple chart was constructed to readily provide the probability of death at the point of care, and a web based calculator is available for a more detailed risk assessment (http://crash2.lshtm.ac.uk).
conclusionsThis prognostic model can be used to obtain valid predictions of mortality in patients with traumatic bleeding, assisting in triage and potentially shortening the time to diagnostic and lifesaving procedures (such as imaging, surgery, and tranexamic acid). Age is an important prognostic factor, and this is of particular relevance in high income countries with an aging trauma population.
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