Trial reportThe journal of trauma and acute care surgery2019
Earlier time to hemostasis is associated with decreased mortality and rate of complications: Results from the Pragmatic Randomized Optimal Platelet and Plasma Ratio trial.
Trial report in The journal of trauma and acute care surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04934384 (The Role of Prehospital eFAST in Accelerating Time to Diagnostics or Definitive Treatment in the Emergency Department), which is not on this map. Cited by 32 papers, 2 of them syntheses 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.
The Role of Prehospital eFAST in Accelerating Time to Diagnostics or Definitive Treatment in the Emergency Department
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 95 citations in OpenAlex.
- Blood transfusion strategies for major bleeding in trauma.The Cochrane database of systematic reviews · 2025Pooled it
- The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition.Critical care (London, England) · 2023Guideline
- Pragmatic O-Positive Whole-blood RandoMizaTion in male trauma Patients (POWeR-MTP).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Trial
- From molecular networks to precision therapeutics: the evolving landscape of trauma-induced coagulopathy.World journal of emergency surgery : WJES · 2026Review
- Potential utility of prehospital blood for trauma patients in a dense, urban setting: simulations of prehospital travel times.Proceedings (Baylor University. Medical Center) · 2026Article
- Association of Preoperative Imaging and Surgical Delay with Hemorrhagic Mortality in Abdominal Trauma: A Retrospective Multicenter Study.Journal of clinical medicine · 2025Article
- Article
- Integrated analysis of WGCNA and machine learning identified diagnostic biomarkers in trauma-induced coagulopathy.Scientific reports · 2025Article
- [Point of care coagulation diagnostics-Absolutely necessary or only a reasonable supplement?]Die Anaesthesiologie · 2025Review
- Early achievement of hemostasis defined by transfusion velocity: A possible mechanism for whole blood survival benefit.The journal of trauma and acute care surgery · 2025Observational
- Is pre-hospital haemoglobin an efficient marker of the need for transfusion and haemorrhagic shock in severe trauma patients? A retrospective observational study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- Resuscitative endovascular balloon occlusion of the aorta, time to definitive hemorrhage control, and mortality.Trauma surgery & acute care open · 2025Article
- REBOA in trauma: a life-saving intervention or a spectacular failure?European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Review
- Prehospital blood transfusion in Brazil: results of the first year of implementation in an emergency medical service.Hematology, transfusion and cell therapy · 2024Article
- Independent factors of preventable death in a mature trauma center: a propensity-score analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Pre-Hospital Blood Products for the Care of Bleeding Trauma Patients.Deutsches Arzteblatt international · 2023Review
- Articles on hemorrhagic shock published between 2000 and 2021: A CiteSpace-Based bibliometric analysis.Heliyon · 2023Article
- Balanced resuscitation and earlier mortality end points: bayesian post hoc analysis of the PROPPR trial.Trauma surgery & acute care open · 2023Article
- Infrastructure, logistics and clinical practice management of acute trauma hemorrhage and coagulopathy: a survey across German trauma centers.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Correcting Coagulopathy for Image-Guided Procedures.Seminars in interventional radiology · 2022Review
Corrections and comments
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Authors and funding
16 authors at 1 institution in 1 country.
Funding
Abstract
backdropClinicians intuitively recognize that faster time to hemostasis is important in bleeding trauma patients, but these times are rarely reported.
methodsProspectively collected data from the Pragmatic Randomized Optimal Platelet and Plasma Ratios trial were analyzed. Hemostasis was predefined as no intraoperative bleeding requiring intervention in the surgical field or resolution of contrast blush on interventional radiology (IR). Patients who underwent an emergent (within 90 minutes) operating room (OR) or IR procedure were included. Mixed-effects Poisson regression with robust error variance (controlling for age, Injury Severity Score, treatment arm, injury mechanism, base excess on admission [missing values estimated by multiple imputation], and time to OR/IR as fixed effects and study site as a random effect) with modified Bonferroni corrections tested the hypothesis that decreased time to hemostasis was associated with decreased mortality and decreased incidence of acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), multiple-organ failure (MOF), sepsis, and venous thromboembolism.
resultsOf 680 enrolled patients, 468 (69%) underwent an emergent procedure. Patients with decreased time to hemostasis were less severely injured, had less deranged base excess on admission, and lower incidence of blunt trauma (all p < 0.05). In 408 (87%) patients in whom hemostasis was achieved, every 15-minute decrease in time to hemostasis was associated with decreased 30-day mortality (RR, 0.97; 95% confidence interval [CI], 0.94-0.99), AKI (RR, 0.97; 95% CI, 0.96-0.98), ARDS (RR, 0.98; 95% CI, 0.97-0.99), MOF (RR, 0.94; 95% CI, 0.91-0.97), and sepsis (RR, 0.98; 95% CI, 0.96-0.99), but not venous thromboembolism (RR, 0.99; 95% CI, 0.96-1.03).
conclusionEarlier time to hemostasis was independently associated with decreased incidence of 30-day mortality, AKI, ARDS, MOF, and sepsis in bleeding trauma patients. Time to hemostasis should be considered as an endpoint in trauma studies and as a potential quality indicator. LEVEL OF EVIDENCE: Therapeutic/care management, level III.
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Registered trials
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.