Evidence map›Paper›PMID 31888722›Full record

Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2019

Impact of a goal-directed factor-based coagulation management on thromboembolic events following major trauma.

Anais L Stein, Julian Rössler, Julia Braun, Kai Sprengel, Patrick E Beeler, Donat R Spahn, Alexander Kaserer, Philipp Stein

Registry-linked trialOpen access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07506473 (Intermediate Versus Standard Dose Enoxaparin to Prevent Venous Thromboembolism in Severe Trauma Patients), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.3field-weighted citation impact, top 11% of its field
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.

NCT07506473 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Intermediate Versus Standard Dose Enoxaparin to Prevent Venous Thromboembolism in Severe Trauma Patients: a Multicenter Double Blind Randomised Controlled Trial

TypeinterventionalSponsorUniversity Hospital, GrenobleRan2026 to 2028Enrolled540ConditionsSevere Trauma Patient, Venous ThromboembolismArmsEnoxaparin standard dose, Enoxaparin intermediate dose
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Trauma-induced coagulopathy.Nature reviews. Disease primers · 2021
    Review
  4. 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

8 authors at 3 institutions in 1 country.

Anais L SteinDepartment of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland.
Julian RösslerInstitute of Anaesthesiology, University and University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Julia BraunDepartments of Biostatistics and Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland.
Kai SprengelDepartment of Trauma, University and University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Patrick E BeelerDepartment of Internal Medicine, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Donat R SpahnInstitute of Anaesthesiology, University and University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Alexander KasererInstitute of Anaesthesiology, University and University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
Philipp SteinInstitute of Anaesthesiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8400, Winterthur, Switzerland. philipp.stein@ksw.ch.ORCID http://orcid.org/0000-0003-1480-0909
University Hospital of Zurich · CHUniversity of Zurich · CHKantonsspital Winterthur · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA factor-based coagulation management following major trauma is recommended as standard of care by the European Trauma Treatment Guidelines. However, concerns about the thromboembolic risk of this approach are still prevalent. Our study therefore aims to assess if such a haemostatic management is associated with an increased risk for thromboembolic events.

methodsIn this retrospective observational study carried out at the University Hospital Zurich we compared two three-year periods before (period 1: 2005-2007) and after (period 2: 2012-2014) implementation of a factor-based coagulation algorithm. We included all adult patients following major trauma primarily admitted to the University Hospital Zurich. Thromboembolic events were defined as a new in-hospital appearance of any peripheral thrombosis, arterial embolism, pulmonary embolism, stroke or myocardial infarction. A logistic regression was performed to investigate the association of thromboembolic events with possible confounders such as age, sex, specific Abbreviated Injury Scale (AIS) subgroups, allogeneic blood products, and the coagulation management.

resultsOut of 1138 patients, 772 met the inclusion criteria: 344 patients in period 1 and 428 patients in period 2. Thromboembolic events were present in 25 patients (7.3%) of period 1 and in 42 patients (9.8%) of period 2 (raw OR 1.39, 95% CI 0.83 to 2.33, p = 0.21). Only AIS extremities (adjusted OR 1.26, 95% CI 1.05 to 1.52, p = 0.015) and exposure to allogeneic blood products (adjusted OR 2.39, 95% CI 1.33 to 4.30, p = 0.004) were independently associated with thromboembolic events in the logistic regression, but the factor-based coagulation management was not (adjusted OR 1.60, 95% CI 0.90-2.86, p = 0.11).

conclusionThere is no evidence that a goal-directed, factor-based coagulation management is associated with an increased risk for thromboembolic events following major trauma.

Indexed as

Abbreviated Injury ScaleAdultAlgorithmsAntifibrinolytic AgentsBlood Coagulation FactorsBlood TransfusionCohort StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesSwitzerlandThromboembolismTrauma CentersWounds and InjuriesAntifibrinolytic AgentsBlood Coagulation FactorsCoagulation factorsCoagulation managementThromboembolic eventsTransfusionTrauma

Identifiers

PMID31888722
PMCPMC6937999
OpenAlexW2997348596

What OpenQuestion holds

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LicenceCC BY
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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.