Evidence map›Paper›PMID 27658942›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2017

Algorithm for activation of coagulation support treatment in multiple injured patients--cohort study.

D Brilej, D Stropnik, R Lefering, R Komadina

Abstract read
PubMed Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. 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

4 authors.

D BrilejTrauma Department, General and Teaching Hospital Celje, Oblakova 5, 3000, Celje, Slovenia. Drago.Brilej@guest.arnes.si.ORCID http://orcid.org/0000-0001-6379-5195
D StropnikTrauma Department, General and Teaching Hospital Celje, Oblakova 5, 3000, Celje, Slovenia.
R LeferingInstitut fur Forschung in der Operative Medizin, Fakultat fur Gesundheit der Universitat Witten/Herdecke, Ostmerheimer str 200, 51109, Koln, Germany.
R KomadinaTrauma Department, General and Teaching Hospital Celje, Oblakova 5, 3000, Celje, Slovenia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly recognition and management of trauma related coagulopathy improves the outcome. Trauma facilities should implement an algorithm to identify the bleeding trauma patient with coagulopathy.

objectiveThe scope of the paper is to identify the indicators of early coagulopathy and to optimize the indications for thromboelastometry and coagulation support.

designCohort study based on data from trauma registry.

settingData of 493 major trauma patients treated in GH Celje from 2006 to 2014 were included into The TraumaRegister DGU PATIENTS: Patients were selected for inclusion into TR-DGU according to the following criteria: polytraumatized patients with Injury severity score (ISS) ≥ 18, patients with injuries to single region with AIS 5, patients with major injuries to a single region and abnormal vital signs. All patients that were dead on arrival to hospital, patients presented to hospital >24 h after the injury, and head injuries that occurred with a low energy mechanism in patients on anticoagulation drugs were excluded. MEASUREMENTS: Two groups were formed (with or without coagulopathy). Mortality, morbidity, length of mechanical ventilation, ICU and hospital stay were used as outcome and compared between the groups. A coagulopathy prediction model (CPM) was developed to identify the patients who were at high risk of coagulopathy.

resultsCoagulopathy was present in 51 % of patients. Severe injuries to the torso and limbs, infusion of >1000 ml of fluids in the prehospital settings, and hypotension were included into CPM. If all three criteria were present, the sensitivity of the model to predict coagulopathy was 93 %. By adding the blood gas analysis (BE ≤ -5), the specificity increased to 81.7 %. LIMITATIONS: Shortcomings of our analysis are mainly related to the quality of data in the registry that may not be comparable to a clinical trial where data are collected specifically to address a given issue.

conclusionsThe Criteria for activation of coagulation support treatment remain centre dependent. In our settings the CPM is the tool to select patients for ROTEM

Indexed as

AlgorithmsMultiple TraumaAdultAgedAge FactorsBlood Coagulation DisordersClinical ProtocolsCohort StudiesFemaleHumansInjury Severity ScoreIntensive Care UnitsLength of StayMaleMiddle AgedModels, TheoreticalCoagulopathyMajor injuryPrediction modelTrauma registry

Identifiers

PMID27658942

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.