ArticleCritical care (London, England)2015
Trauma-induced coagulopathy: impact of the early coagulation support protocol on blood product consumption, mortality and costs.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition.Critical care (London, England) · 2023Guideline
- Pooled it
- Efficacy of fibrinogen concentrate in major abdominal surgery - A prospective, randomized, controlled study in cytoreductive surgery for pseudomyxoma peritonei.Journal of thrombosis and haemostasis : JTH · 2020Trial
- 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
- From single to dual platelet inhibition FIBTEM assay: fibrinogen replacement thresholds for critical bleeding after trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Multicenter survey on viscoelastic assays access and use in trauma in Swiss emergency departments.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Risk factors and preliminary prediction models for trauma-induced coagulopathy and 28-day mortality in severely injured patients: a retrospective observational cohort study.Frontiers in medicine · 2026Article
- Viscoelastic Hemostatic Assays in the Management of Trauma-Induced Coagulopathy: A Clinical Update.Journal of clinical medicine · 2025Review
- The influence of rotational thromboelastometry (ROTEM) on operating room and intensive care transfusion practices in major trauma bleeding: a prospective cohort study with historical control.Perioperative medicine (London, England) · 2025Article
- Evaluation of acute traumatic coagulopathy in pediatric trauma patients.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2025Article
- Emulsion-Based Encapsulation of Fibrinogen with Calcium Carbonate for Hemorrhage Control.Journal of functional biomaterials · 2025Article
- Update on the pathophysiology and management of acute trauma hemorrhage and trauma-induced coagulopathy based upon viscoelastic testing.Clinical and experimental emergency medicine · 2024Article
- Development and validation of the tic score for early detection of traumatic coagulopathy upon hospital admission: a cohort study.Critical care (London, England) · 2024Article
- Establishment of a model to predict mortality after decompression craniotomy for traumatic brain injury.Brain and behavior · 2024Article
- Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management: Management of critical bleeding.Hematology, transfusion and cell therapy · 2024Article
- The role of fibrinogen in traumatic brain injury: from molecular pathological mechanisms to clinical management.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Review
- Thromboelastometry-guided haemostatic resuscitation in severely injured patients: a propensity score-matched study.Critical care (London, England) · 2023Article
- Coagulopathy management of multiple injured patients - a comprehensive literature review of the European guideline 2019.EFORT open reviews · 2022Review
- Dynamic use of fibrinogen under viscoelastic assessment results in reduced need for plasma and diminished overall transfusion requirements in severe trauma.The journal of trauma and acute care surgery · 2022Article
- Viscoelastic Hemostatic Assays for Orthopedic Trauma and Elective Procedures.Journal of clinical medicine · 2022Review
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHemorrhage is the principal cause of death in the first few hours following severe injury. Coagulopathy is a frequent complication of critical bleeding. A network of Italian trauma centers recently developed a protocol to prevent and treat trauma-induced coagulopathy. A pre-post cohort multicenter study was conducted to assess the impact of the early coagulation support (ECS) protocol on blood products consumption, mortality and treatment costs.
methodsWe prospectively collected data from all severely injured patients (Injury Severity Score (ISS) >15) admitted to two trauma centers in 2013 and compared these findings with the data for 2011. Patients transfused with at least 3 units of packed red blood cells (PRBCs) within 24 hours of an accident were included in the study. In 2011, patients with significant hemorrhaging were treated with early administration of plasma with the aim of achieving a high (≥1:2) plasma-to-PRBC ratio. In 2013, the ECS protocol was the treatment strategy. Outcome data, blood product consumption and treatment costs were compared between the two periods.
resultsThe two groups were well matched for demographics, injury severity (ISS: 32.9 in 2011 versus 33.6 in 2013) and clinical and laboratory data on admission. In 2013, a 40% overall reduction in PRBCs was observed, together with a 65% reduction in plasma and a 52% reduction in platelets. Patients in the ECS group received fewer blood products: 6.51 units of PRBCs versus 8.14 units. Plasma transfusions decreased from 8.98 units to 4.21 units (P <0.05), and platelets fell from 4.14 units to 2.53 units (P <0.05). Mortality in 2013 was 13.5% versus 20% in 2011 (13 versus 26 hospital deaths, respectively) (nonsignificant). When costs for blood components, factors and point-of-care tests were compared, a €76,340 saving in 2013 versus 2011 (23%) was recorded.
conclusionsThe introduction of the ECS protocol in two Italian trauma centers was associated with a marked reduction in blood product consumption, reaching statistical significance for plasma and platelets, and with a non-significant trend toward a reduction in early and 28-day mortality. The overall costs for transfusion and coagulation support (including point-of-care tests) decreased by 23% between 2011 and 2013.
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