Observational studySurgery2018
Abnormalities of laboratory coagulation tests versus clinically evident coagulopathic bleeding: results from the prehospital resuscitation on helicopters study (PROHS).
Observational study in Surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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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
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pre-hospital transfusion of red blood cells. Part 2: A systematic review of treatment effects on outcomes.Transfusion medicine (Oxford, England) · 2020Pooled it
- Unique Pattern of Coagulopathy Among Patients With Severe Traumatic Brain Injury: A Principal Component Analysis of Hemorrhagic Shock Trials.Critical care medicine · 2026Article
- Early Thrombocytopenia at Hospital Admission Predicts Mortality in Patients with Non-Isolated Severe Traumatic Brain Injury.Biomedicines · 2024Article
- Clinical phenotypes and short-term outcomes based on prehospital point-of-care testing and on-scene vital signs.NPJ digital medicine · 2024Article
- Novel Prehospital Phenotypes and Outcomes in Adult-Patients with Acute Disease.Journal of medical systems · 2022Article
- Variations and obstacles in the use of coagulation factor concentrates for major trauma bleeding across Europe: outcomes from a European expert meeting.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Review
- Hemorrhagic Resuscitation Guided by Viscoelastography in Far-Forward Combat and Austere Civilian Environments: Goal-Directed Whole-Blood and Blood-Component Therapy Far from the Trauma Center.Journal of clinical medicine · 2022Review
- Trauma-induced coagulopathy.Nature reviews. Disease primers · 2021Review
- A clinical coagulopathy score concurrent with viscoelastic testing defines opportunities to improve hemostatic resuscitation and enhance blood product utilization during liver transplantation.American journal of surgery · 2020Article
- Pre-hospital transfusion of red blood cells. Part 1: A scoping review of current practice and transfusion triggers.Transfusion medicine (Oxford, England) · 2020Article
- Microvesicles generated following traumatic brain injury induce platelet dysfunction via adenosine diphosphate receptor.The journal of trauma and acute care surgery · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
24 authors.
Funding
Abstract
backgroundLaboratory-based evidence of coagulopathy (LC) is observed in 25-35% of trauma patients, but clinically-evident coagulopathy (CC) is not well described.
methodsProspective observational study of adult trauma patients transported by helicopter from the scene to nine Level 1 trauma centers in 2015. Patients meeting predefined highest-risk criteria were divided into CC+ (predefined as surgeon-confirmed bleeding from uninjured sites or injured sites not controllable by sutures) or CC-. We used a mixed-effects, Poisson regression with robust error variance to test the hypothesis that abnormalities on rapid thrombelastography (r-TEG) and international normalized ratio (INR) were independently associated with CC+.
resultsOf 1,019 highest-risk patients, CC+ (n=41, 4%) were more severely injured (median ISS 32 vs 17), had evidence of LC on r-TEG and INR, received more transfused blood products at 4 hours (37 vs 0 units), and had greater 30-day mortality (59% vs 12%) than CC- (n=978, 96%). The overall incidence of LC was 39%. 30-day mortality was 22% vs 9% in those with and without LC. In two separate models, r-TEG K-time >2.5 min (RR 1.3, 95% CI 1.1-1.7), r-TEG mA <55 mm (RR 2.5, 95% CI 2.0-3.2), platelet count <150 x 10
conclusionCC was rare compared to LC. CC was associated with poor outcomes and impairment of both clotting factor and platelet-mediated coagulation components.
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Registered trials
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