Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2018
Comparison of two different coagulation algorithms on the use of allogenic blood products and coagulation factors in severely injured trauma patients: a retrospective, multicentre, observational study.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 25 citations in OpenAlex.
- Acquired factor XIII deficiency in adult patients during ECMO: a prospective observational study.Scientific reports · 2025Observational
- A comparison of the optical method with the mechanical method in routine coagulation tests.Journal of medical biochemistry · 2025Article
- Coagulation Factor XIII - Last to think about?Blood transfusion = Trasfusione del sangue · 2025Article
- [Update on point-of-care-based coagulation treatment : Systems, reagents, device-specific treatment algorithms].Die Anaesthesiologie · 2024Review
- The impact of acquired coagulation factor XIII deficiency in traumatic bleeding and wound healing.Critical care (London, England) · 2022Review
- Pre-hospital trauma care in Switzerland and Germany: do they speak the same language?European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- High Interleukin-6 Plasma Concentration upon Admission Is Predictive of Massive Transfusion in Severely Injured Patients.Journal of clinical medicine · 2021Article
- Physicians' perceptions regarding acute bleeding management: an international mixed qualitative quantitative study.BMC anesthesiology · 2021Article
- Whole Blood, Fixed Ratio, or Goal-Directed Blood Component Therapy for the Initial Resuscitation of Severely Hemorrhaging Trauma Patients: A Narrative Review.Journal of clinical medicine · 2021Review
- Impact of a goal-directed factor-based coagulation management on thromboembolic events following major trauma.Scandinavian journal of trauma, resuscitation and emergency medicine · 2019Observational
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
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Abstract
backgroundAt the University Hospital Zurich (USZ) and the Cantonal Hospital of Lucerne (LUKS) an individualized goal-directed coagulation and transfusion algorithm was introduced and implemented before 2012 (Coagulation algorithm of the USZ: USZ-Alg; of the LUKS: LUKS-Alg). Main differences between both algorithms are: 1) A target haematocrit-range of 0.21-0.24 (USZ-Alg) vs. a lower haematocrit limit only (LUKS-Alg). 2) Blind coagulation-package in selected cases (LUKS-Alg only). 3) Factor XIII substitution is considered earlier according to the USZ-Alg. The Aim of this study was to analyse the impact of two different coagulation algorithms on the administration of allogeneic blood products, coagulation factors, the frequency of point of care measurements and haemoglobin level during resuscitation in trauma patients.
methodsThis retrospective, multicentre, observational study included all adult trauma patients with an injury severity score (ISS) ≥ 16 primarily admitted to the USZ or the LUKS in the period of 2012 to 2014. Referred patients and patients with missing/incomplete records of the initial treatment at the emergency department (ED) were excluded. Two propensity score matched groups were created using a non-parsimonious logistic regression to account for potential differences in patient and trauma epidemiology.
resultsA total of 632 patients meeting the inclusion criteria were admitted to the two hospitals: 428 to the USZ and 204 to the LUKS. Two Propensity score matched groups (n = 172 per group) were created. Treatment with USZ-Alg compared with LUKS-Alg resulted in a lower number of patients receiving RBC transfusion (11.6% vs. 29.7%, OR 3.2, 95% CI 1.8-5.7, p < 0.001) and lower amount of RBC transfusion (0.5 SD 1.9 vs. 1.5 SD 3.9, p < 0.001). The different treatment algorithms resulted in lower mean haemoglobin levels in the USZ during resuscitation (8.0 SD 1.7 vs. 9.4 SD 1.8 g/dl, p < 0.001) and at admission to the ICU (8.3 SD 1.2 vs. 10.6 SD 1.9 g/dl, p < 0.001. Blood gas analyses to monitor treatment and haematocrit were made more frequently in the USZ (1.4 SD 0.8 vs. 1.0 SD 0.7 measurements per hour, p = 0.004).
conclusionA goal-directed coagulation algorithm including a target haematocrit-range including frequent and repeated haematocrit measurement may lead to less transfusion of RBC compared to only a lower haematocrit limit, when treating severely traumatized patients.
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