Evidence map›Paper›PMID 26815834›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2012

Prehospital HMG Co-A reductase inhibitor use and reduced mortality in hemorrhagic shock due to trauma.

J M Feeney, V Jayaraman, J Spilka, D S Shapiro, S Ellner, W T Marshall, L M Jacobs

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 40% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

J M FeeneyDepartment of Surgery, Saint Francis Hospital and Medical Center, 114 Woodland Street, Hartford, CT, 06103, USA. jfeeney@stfranciscare.org.
V JayaramanDepartment of Traumatology and Emergency Medicine, Hartford Hospital, 80 Seymour Street, Hartford, CT, 06102, USA.
J SpilkaUniversity of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT, 06030, USA.
D S ShapiroDepartment of Surgery, Saint Francis Hospital and Medical Center, 114 Woodland Street, Hartford, CT, 06103, USA.
S EllnerDepartment of Surgery, Saint Francis Hospital and Medical Center, 114 Woodland Street, Hartford, CT, 06103, USA.
W T MarshallDepartment of Surgery, Saint Francis Hospital and Medical Center, 114 Woodland Street, Hartford, CT, 06103, USA.
L M JacobsDepartment of Surgery, Saint Francis Hospital and Medical Center, 114 Woodland Street, Hartford, CT, 06103, USA.
Saint Francis University · USUniversity of Connecticut · USHartford Hospital · USSaint Francis Hospital & Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction3-Hydroxy-3-methyl-glutaryl Co-A reductase inhibitors (HMG Co-A reductase inhibitors, statins) are commonly used medications for the control of serum cholesterol. Recent data suggests that these medications also modify the inflammatory pathways in sepsis, septic shock, and hemorrhagic shock due to ruptured abdominal aortic aneurysms. Statin use in hemorrhagic shock due to trauma, however, has conflicting data, with one study showing improvement, but only in certain subsets of patients. STUDY

designWe retrospectively reviewed the medical records of patients from our institution's trauma registry database from January 2000 to December 2008. We included patients with an age greater than 45 years and an Injury Severity Score (ISS) greater than 15 with evidence of shock as follows: hypotension, elevated serum lactate, base deficit, metabolic acidosis, or objective evidence of end-organ malperfusion. We excluded patients with devastating head injury, patients with pre-existing advance directives directing against life-sustaining measures, patients for whom family or health care proxies withdrew support in 24 h or less, and patients who succumbed to their injuries in the first 24 h in the hospital. We compared age, gender, mortality, statin use, aspirin use, and Sequential Organ Failure Assessment (SOFA) scores.

resultsMortality in the group without prehospital statin use was 38.1% (95% confidence interval [CI]: 28.4-48.8%) and mortality in the group with prehospital statin use was 8.3% (95% CI: 2.13-22.5%, P = 0.0009). The absolute risk reduction was 29.8% and the relative risk reduction was 78.1%. Survivors were statistically significantly younger than nonsurvivors in the group without prehospital statin use, but not in the group with documented prehospital statin use. There was no similar benefit to aspirin use. There were no significant differences in the SOFA scores, hospital length of stay (HLOS), or intensive care unit length of stay (ICU LOS) between statin users and nonusers.

conclusionsPrehospital HMG Co-A reductase use was associated with improved survival in a population with severe trauma and evidence of ongoing hemorrhagic shock.

Indexed as

Abdominal traumaInflammationPolytraumaShock

Identifiers

PMID26815834
OpenAlexW2074941500

What OpenQuestion holds

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Registered trials

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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.