Evidence map›Paper›PMID 31627715›Full record

Trial reportBMC emergency medicine2019

Introduction of a standardised protocol, including systematic use of tranexamic acid, for management of severe adult trauma patients in a low-resource setting: the MSF experience from Port-au-Prince, Haiti.

Alessandro Jachetti, Rose Berly Massénat, Nathalie Edema, Sophia C Woolley, Guido Benedetti, Rafael Van Den Bergh, Miguel Trelles

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMC emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. Review
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.

Alessandro JachettiMédecins Sans Frontières - Operational Centre Brussels - Haiti Mission, Port-au-Prince, Haiti. alessandro.jachetti@policlinico.mi.it.ORCID 0000-0001-8769-0355
Rose Berly MassénatMédecins Sans Frontières - Operational Centre Brussels - Haiti Mission, Port-au-Prince, Haiti.
Nathalie EdemaMédecins Sans Frontières - Operational Centre Brussels - Haiti Mission, Port-au-Prince, Haiti.
Sophia C WoolleyMédecins Sans Frontières - Operational Centre Brussels - Haiti Mission, Port-au-Prince, Haiti.
Guido BenedettiMédecins Sans Frontières - Operational Centre Brussels - Haiti Mission, Port-au-Prince, Haiti.
Rafael Van Den BerghMédecins Sans Frontières - Operational Centre Brussels - Operational Research Unit, Brussels, Belgium.
Miguel TrellesMédecins Sans Frontières - Operational Centre Brussels - Surgical and Critical Care Unit, Brussels, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBleeding is an important cause of death in trauma victims. In 2010, the CRASH-2 study, a multicentre randomized control trial on the effect of tranexamic acid (TXA) administration to trauma patients with suspected significant bleeding, reported a decreased mortality in randomized patients compared to placebo. Currently, no evidence on the use of TXA in humanitarian, low-resource settings is available. We aimed to measure the hospital outcomes of adult patients with severe traumatic bleeding in the Médecins Sans Frontières Tabarre Trauma Centre in Port-au-Prince, Haiti, before and after the implementation of a Massive Haemorrhage protocol including systematic early administration of TXA.

methodsPatients admitted over comparable periods of four months (December2015- March2016 and December2016 - March2017) before and after the implementation of the Massive Haemorrhage protocol were investigated. Included patients had blunt or penetrating trauma, a South Africa Triage Score ≥ 7, were aged 18-65 years and were admitted within 3 h from the traumatic event. Measured outcomes were hospital mortality and early mortality rates, in-hospital time to discharge and time to discharge from intensive care unit.

resultsOne-hundred and sixteen patients met inclusion criteria. Patients treated after the introduction of the Massive Haemorrhage protocol had about 70% less chance of death during hospitalization compared to the group "before" (adjusted odds ratio 0.3, 95%confidence interval 0.1-0.8). They also had a significantly shorter hospital length of stay (p = 0.02).

conclusionsImplementing a Massive Haemorrhage protocol including early administration of TXA was associated with the reduced mortality and hospital stay of severe adult blunt and penetrating trauma patients in a context with poor resources and limited availability of blood products.

Indexed as

AdolescentAdultAgedAntifibrinolytic AgentsClinical ProtocolsDeveloping CountriesFemaleHaitiHemorrhageHumansMaleMiddle AgedRetrospective StudiesTranexamic AcidTriageWounds and InjuriesAntifibrinolytic AgentsTranexamic AcidEmergency roomHaitiLow-resource settingMedécins sans FrontièresTranexamic acidTrauma

Identifiers

PMID31627715
PMCPMC6798378

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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.