Evidence map›Paper›PMID 41504542›Full record

ArticleCritical care medicine2026

Unique Pattern of Coagulopathy Among Patients With Severe Traumatic Brain Injury: A Principal Component Analysis of Hemorrhagic Shock Trials.

Leah M Furman, Nazih Bizri, Erin V Feeney, Barbara A Gaines, Francis X Guyette, Ernest E Moore, John B Holcomb, Jason L Sperry, Christine M Leeper

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In one paragraph

Article in Critical care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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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

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1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Leah M FurmanDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.ORCID 0000-0002-4105-4043
Nazih BizriDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Erin V FeeneyDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Barbara A GainesDepartment of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Francis X GuyetteDepartment of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
Ernest E MooreDepartment of Surgery, University of Colorado Denver, Denver, CO.
John B HolcombDepartment of Surgery, University of Alabama Birmingham, Birmingham, AL.
Jason L SperryDepartment of Surgery and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
Christine M LeeperDepartment of Surgery and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.

Funding

TRAINING IN TRAUMA AND SEPSIS RESEARCHT32GM008516 · NIGMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI TIMOTHY R BILLIAR · 1994 to 2026
$9.4M
NIGMS NIH HHS T32 GM008516
6 · The paper itself

Abstract

objectivesTrauma-induced coagulopathy biomarkers may be influenced by injury mechanism. We sought to identify differences in patterns of coagulopathy with and without severe traumatic brain injury (TBI).

designRetrospective cohort study.

settingHarmonized database composed of six major hemorrhagic shock trials: Control of Major Bleeding After Trauma (COMBAT), Cold-stored Platelet Early Intervention in Hemorrhagic Shock (CriSP-HS), Prehospital Air Medical Plasma (PAMPer), Prehospital Whole Blood in Emergency Resuscitation (PPOWER), Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR), and Study of Tranexamic Acid During Air Medical and Ground Prehospital Transport (STAAMP). PATIENTS: All subjects randomized to placebo or standard-of-care groups with complete data for international normalized ratio (INR), thromboelastography values (alpha angle [AA], K time, maximum amplitude [MA], and lysis in 30 min), and Abbreviated Injury Scores (AISs). Subjects from COMBAT and CriSP-HS were screened and ultimately excluded from the final analysis as they did not meet eligibility criteria.

interventionsNone. MEASUREMENTS AND MAIN

resultsStratified principal component (PC) analysis was performed for INR and thromboelastography values. Strata were defined based on AIS scores as: 1) isolated severe TBI (iTBI); 2) severe polytrauma (POLY), those with both major head injury and torso/extremity trauma; and 3) isolated severe torso/extremity trauma (iTRUNK). We identified 506 subjects with complete data: 51 iTBI, 115 POLY, and 340 iTRUNK. For each stratum, two PCs were identified that accounted for more than 65% of the variance. Associations between PC scores and outcomes, including need for blood product transfusion within 24 hours as a surrogate marker for early coagulopathy and bleeding, were examined with logistic regression. For both iTBI and POLY, PC1 included INR, AA, K time, and MA, and was associated with greater odds of early transfusion (odds ratio [OR], 3.57; 95% CI, 1.50-8.45; p = 0.004 for iTBI and OR, 2.29; 95% CI, 1.11-4.75; p = 0.026 for POLY). For iTRUNK, PC1 included INR, AA, and MA and was protective with reduced odds of early transfusion (OR, 0.51; 95% CI, 0.37-0.70; p < 0.001).

conclusionsPC analysis demonstrated a unique pattern of coagulation biomarkers common to patients with severe TBI, irrespective of other injuries.

Indexed as

Blood Coagulation DisordersBrain Injuries, TraumaticShock, HemorrhagicAdultBiomarkersFemaleHumansInternational Normalized RatioMaleMiddle AgedPrincipal Component AnalysisRetrospective StudiesThrombelastographyBiomarkersbloodbrain injuriescoagulation disordersmultiple traumaprincipal component analysisshock

Identifiers

PMID41504542
PMCPMC12875202

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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.