ReviewAnnals of surgery2015
Detailed description of all deaths in both the shock and traumatic brain injury hypertonic saline trials of the Resuscitation Outcomes Consortium.
Review in Annals of surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 101 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
101 citing papers in PubMed, 5 syntheses or guidelines pooled it, 236 citations in OpenAlex.
- Neutrophil cell surface receptor dynamics following trauma: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- The effect of external bleeding control training courses on lay first-person responders'knowledge, skills, and attitudes in low- and middle-income countries: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Platelet-to-red blood cell ratio and mortality in bleeding trauma patients: A systematic review and meta-analysis.Transfusion · 2021Pooled it
- Freeze-dried plasma for major trauma - Systematic review and meta-analysis.The journal of trauma and acute care surgery · 2021Pooled it
- Pooled it
- Trial
- Early fibrinogen concentrate therapy for major haemorrhage in trauma (E-FIT 1): results from a UK multi-centre, randomised, double blind, placebo-controlled pilot trial.Critical care (London, England) · 2018Trial
- Goal-directed Hemostatic Resuscitation of Trauma-induced Coagulopathy: A Pragmatic Randomized Clinical Trial Comparing a Viscoelastic Assay to Conventional Coagulation Assays.Annals of surgery · 2016Trial
- Trial
- Approach to Optimizing Tranexamic Acid Use in Trauma: Potential Utilization of Trauma Phenotypes.Thrombosis and haemostasis · 2026Review
- Modeling Hemorrhagic Shock in Male SD Rats by Fixed Volume Blood Withdrawal Followed by Partial Resuscitation and Long-Term Outcome Assessment.Medical sciences (Basel, Switzerland) · 2026Article
- Characterization of the binding of skeletal muscle myosin to fibrin in trauma.The journal of trauma and acute care surgery · 2026Article
- Whole blood first resuscitation and association of blood product utilization based on mechanism of injury.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Association between high ratio of platelet concentrate to red blood cell and survival among massively transfused patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Thoracic vascular injury remains the leading cause of death in traumatic haemorrhage: Analysis of injury patterns and time to death.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Ghost in the Machine: Leveraging artificial intelligence in the trauma bay.Trauma surgery & acute care open · 2026Review
- Performance of four scoring systems in predicting the need for massive transfusion in Iranian trauma patients.PloS one · 2026Article
- A novel role for ADAMTS13 in hyperfibrinolysis after trauma-induced shockBritish journal of anaesthesia · 2026Article
- Article
- Evaluating the relationship between 24-h urine output and clinical outcomes in critically injured trauma patients: a retrospective cohort study.European journal of medical research · 2025Article
41 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 7 institutions in 2 countries.
Funding
Abstract
objectiveTo identify causes and timing of mortality in trauma patients to determine targets for future studies.
backgroundIn trials conducted by the Resuscitation Outcomes Consortium in patients with traumatic hypovolemic shock (shock) or traumatic brain injury (TBI), hypertonic saline failed to improve survival. Selecting appropriate candidates is challenging.
methodsRetrospective review of patients enrolled in multicenter, randomized trials performed from 2006 to 2009. Inclusion criteria were as follows: injured patients, age 15 years or more with hypovolemic shock [systolic blood pressure (SBP) ≤ 70 mm Hg or SBP 71-90 mm Hg with heart rate ≥ 108) or severe TBI [Glasgow Coma Score (GCS) ≤ 8]. Initial fluid administered was 250 mL of either 7.5% saline with 6% dextran 70, 7.5% saline or 0.9% saline.
resultsA total of 2061 subjects were enrolled (809 shock, 1252 TBI) and 571 (27.7%) died. Survivors were younger than nonsurvivors [30 (interquartile range 23) vs 42 (34)] and had a higher GCS, though similar hemodynamics. Most deaths occurred despite ongoing resuscitation. Forty-six percent of deaths in the TBI cohort were within 24 hours, compared with 82% in the shock cohort and 72% in the cohort with both shock and TBI. Median time to death was 29 hours in the TBI cohort, 2 hours in the shock cohort, and 4 hours in patients with both. Sepsis and multiple organ dysfunction accounted for 2% of deaths.
conclusionsMost deaths from trauma with shock or TBI occur within 24 hours from hypovolemic shock or TBI. Novel resuscitation strategies should focus on early deaths, though prevention may have a greater impact.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.