Observational studyCritical care medicine2015
An International Normalized Ratio-Based Definition of Acute Traumatic Coagulopathy Is Associated With Mortality, Venous Thromboembolism, and Multiple Organ Failure After Injury.
Observational study in Critical care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02736812 (Interest of Pre-hospital Administration of Lyophilized Plasma to Prevent or Treat Coagulopathy Associated With Post-traumatic Hemorrhagic Shock), which is not on this map. Cited by 60 papers, 1 of them a synthesis 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.
Interest of Pre-hospital Administration of Lyophilized Plasma to Prevent or Treat Coagulopathy Associated With Post-traumatic Hemorrhagic Shock (PREHO-PLYO Study )
Who cites it
60 citing papers in PubMed, 1 synthesis or guideline pooled it, 138 citations in OpenAlex.
- Early Identification of Acute Traumatic Coagulopathy Using Clinical Prediction Tools: A Systematic Review.Medicina (Kaunas, Lithuania) · 2019Pooled it
- High ratio of plasma to red cells in contemporary resuscitation of haemorrhagic shock after trauma: a secondary analysis of the PATCH-trauma trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Trial
- Trauma-Induced Coagulopathy: From Endotheliopathy and Fibrinolysis Phenotypes to Viscoelastic-Guided Resuscitation.European journal of haematology · 2026Review
- A stochastic, physiology-based digital twin model of hemostasis and oxygenation in trauma resuscitation.Research square · 2026Article
- Syndecan-1 Levels in Trauma and Burn Patients Remain Elevated During Resuscitation and Correlate With Coagulopathy.Journal of the American College of Emergency Physicians open · 2026Article
- Article
- Article
- Bleeding resuscitation in the ambulance service, an observational study of standard care in Sweden.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Observational
- Predicting postoperative trauma-induced coagulopathy in patients with severe injuries by machine learning.Scientific reports · 2025Article
- Comparison of conventional coagulation tests and ROTEM in identifying trauma-induced coagulopathy for massive haemorrhage protocol activation.Transfusion medicine (Oxford, England) · 2025Observational
- The Characteristics of Severely Injured Trauma Patients Admitted to a Level I Trauma Center with Pre-Injury Use of Oral Anticoagulation (OAC) or Antiplatelet Therapy (APT).Journal of clinical medicine · 2025Article
- Explainable machine learning model for prediction of 28-day all-cause mortality in immunocompromised patients in the intensive care unit: a retrospective cohort study based on MIMIC-IV database.European journal of medical research · 2025Article
- Altered thrombin generation with prothrombin complex concentrate is not detected by viscoelastic testing: an in vitro study.British journal of anaesthesia · 2025Article
- Utility of point of care viscoelastic haemostatic assays for trauma patients in the emergency department.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Observational
- Conventional Coagulation Tests are a better predictor of mortality than Viscoelastic Haemostatic Assays in trauma patients with shock: a prospective observational study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- HMGB-1 as a predictor of major bleeding requiring activation of a massive transfusion protocol in severe trauma.Scientific reports · 2025Observational
- Observational
- Sex-Based Differences in Polytraumatized Patients between 1995 and 2020: Experiences from a Level I Trauma Center.Journal of clinical medicine · 2024Article
- Nonsteroidal Anti-Inflammatory Drugs Decrease Coagulopathy Incidence in Severe Burn Patients.European burn journal · 2024Article
- Blood Transfusion for Major Trauma in Emergency Department.Diagnostics (Basel, Switzerland) · 2024Review
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectivesAcute traumatic coagulopathy is associated with adverse outcomes including death. Previous studies examining acute traumatic coagulopathy's relation with mortality are limited by inconsistent criteria for syndrome diagnosis, inadequate control of confounding, and single-center designs. In this study, we validated the admission international normalized ratio as an independent risk factor for death and other adverse outcomes after trauma and compared two common international normalized ratio-based definitions for acute traumatic coagulopathy.
designMulticenter prospective observational study.
settingNine level I trauma centers in the United States. PATIENTS: A total of 1,031 blunt trauma patients with hemorrhagic shock.
interventionsNone. MEASUREMENTS AND MAIN
resultsInternational normalized ratio exhibited a positive adjusted association with all-cause in-hospital mortality, hemorrhagic shock-associated in-hospital mortality, venous thromboembolism, and multiple organ failure. Acute traumatic coagulopathy affected 50% of subjects if defined as an international normalized ratio greater than 1.2 and 21% of subjects if defined by international normalized ratio greater than 1.5. After adjustment for potential confounders, acute traumatic coagulopathy defined as an international normalized ratio greater than 1.5 was significantly associated with all-cause death (odds ratio [OR], 1.88; p < 0.001), hemorrhagic shock-associated death (OR, 2.44; p = 0.001), venous thromboembolism (OR, 1.73; p < 0.001), and multiple organ failure (OR, 1.38; p = 0.02). Acute traumatic coagulopathy defined as an international normalized ratio greater than 1.2 was not associated with an increased risk for the studied outcomes.
conclusionsElevated international normalized ratio on hospital admission is a risk factor for mortality and morbidity after severe trauma. Our results confirm this association in a prospectively assembled multicenter cohort of severely injured patients. Defining acute traumatic coagulopathy by using an international normalized ratio greater than 1.5 but not an international normalized ratio greater than 1.2 identified a clinically meaningful subset of trauma patients who, adjusting for confounding factors, experienced more adverse outcomes. Targeting future therapies for acute traumatic coagulopathy to patients with an international normalized ratio greater than 1.5 may yield greater returns than using a lower international normalized ratio threshold.
Indexed as
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.