Evidence map›Paper›PMID 41774107›Full record

Trial reportIntensive care medicine2026

Influence of multiple trauma on the effect of transfusion strategies in patients with traumatic brain injury: a sub-study of the HEMOTION trial.

Marwan Bouras, François Lauzier, Dean A Fergusson, Xavier Neveu, Lucy Clayton, Marie-Pier Patton, Olivier Costerousse, Shane W English, Annemarie Docherty, Luiz M S Malbouisson and 30 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Intensive 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.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

40 authors.

Marwan BourasCentre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada.
François LauzierCentre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada.
Dean A FergussonOttawa Hospital Research Institute, Ottawa, Canada.
Xavier NeveuCentre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada.
Lucy ClaytonCentre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada.
Marie-Pier PattonCentre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada.
Olivier CosterousseCentre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada.
Shane W EnglishOttawa Hospital Research Institute, Ottawa, Canada.
Annemarie DochertyUsher Institute of Population Health Sciences, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK.
Luiz M S MalbouissonSurgical Intensive Care Unit, Anesthesiology Division, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
Ryan ZarychanskiDepartment of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Lynne MooreDepartment of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Quebec City, Canada.
Paule Lessard BonaventureDepartment of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Quebec City, Canada.
Vincent LarocheCentre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada.
Michael VerretCentre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada.
Damon C ScalesDepartment of Critical Care Medicine, Sunnybrook Health Sciences Center and Sunnybrook Research Institute, Toronto, Canada.
Neill K J AdhikariDepartment of Critical Care Medicine, Sunnybrook Health Sciences Center and Sunnybrook Research Institute, Toronto, Canada.
Jonathan GreenbaumSalford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK.
Andreas KramerDepartments of Critical Care Medicine and Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
Vanesa Garnelo ReySt Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
Ian BallDepartment of Medicine and Department of Epidemiology and Biostatistics, Western University, London, Canada.
Kosar KhwajaDepartments of Surgery and Critical Care Medicine, McGill University Health Centre, Montreal, Canada.
Matt WiseCardiff University, Cardiff, UK.
Daniel HarveyNottingham University Hospitals NHS Trust, Nottingham, UK.
Russell ChabanneDépartement Anesthésie Réanimation Et Médecine Périopératoire, Centre Hospitalier Universitaire (CHU) de Clermont-Ferrand, Clermont-Ferrand, France.
Julien PottecherHôpital de Hautepierre, Service d'Anesthésie-Réanimation Et Médecine Péri-Opératoire, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Jonathan RhodesUsher Institute of Population Health Sciences, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK.
Andrea RigamontiInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.
Karen E A BurnsInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada.
Donald E GriesdaleDepartment of Medicine, Division of Critical Care Medicine, Faculty of Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.
Demetrios James KutsogiannisDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
Robert GreenTrauma Nova Scotia, Nova Scotia Health, Halifax, Canada.
J Gordon BoydDepartment of Medicine, Division of Neurology, School of Medicine, Queen's University, Kingston, Canada.
Frederick ZeilerBiomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, Canada.
Alwyn GomezDepartment of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Emmanuel CharbonneyDepartment of Medicine, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Canada.
Timothy AstlesDepartment of Intensive Care Medicine, Liverpool University Hospitals NHS, Liverpool, UK.
Eric SyCollege of Medicine, University of Saskatchewan, Regina, Canada.
Alexis F TurgeonCentre Hospitalier Universitaire (CHU) de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada. alexis.turgeon@crchudequebec.ulaval.ca.ORCID 0000-0001-5675-8791
HEMOTION Trial investigators, the Canadian Critical Care Trials Group, the Canadian Perioperative Anesthesia Clinical Trials Group, the Canadian Traumatic Brain Injury Research Consortium

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn moderate-to-severe traumatic brain injury (TBI), anemia may exacerbate secondary cerebral injury, and patients with multiple trauma may be especially vulnerable to cerebral hypoxia. We conducted a secondary analysis of the HEMOTION trial (liberal transfusion strategy > 10 g/dL vs. restrictive > 7 g/dL), to assess whether multiple trauma modifies the effect of transfusion strategy after moderate-to-severe TBI.

methodsWe included all HEMOTION trial participants (n = 742) and defined multiple trauma using three definitions: (1) extracranial injury with Injury Severity Score (ISS) > 15; (2) extracranial injury requiring emergency extracranial surgery; (3) spinal injury with neurological deficit. The primary outcome was the 6-month Glasgow Outcome Scale Extended (GOS-E). We tested interactions between transfusion strategy and multiple trauma status using sliding dichotomy and hierarchical Poisson regression, with sensitivity analyses using classical dichotomy (GOS-E ≤ 4) and proportional odds models. Secondary outcomes included mortality, quality of life (EQ-5D-5L, QOLIBRI), functional independence (FIM), and depression (PHQ-9).

resultsWe found no interaction between multiple trauma status and transfusion strategies on the 6-month GOS-E across all three definitions. The adjusted relative risk (RR) of an unfavourable outcome with the liberal strategy was 0.87 (95% CI 0.71-1.07) for patients with ISS > 15, 0.79 (0.59-1.05) for emergency extracranial surgery, and 0.99 (0.42-2.33) for spinal cord injury. Sensitivity analyses suggested a potential interaction for patients undergoing emergency extracranial surgery (p-interaction = 0.02 for proportional odds analysis; 0.05 for classical dichotomy). A liberal strategy was associated with better FIM, EQ-5D-5L, and Qolibri scores for definitions 1 and 2, but not 3, with no consistent interaction. Mortality and PHQ-9 did not differ.

conclusionMultiple trauma status was not associated with the effect of liberal vs. restrictive transfusion strategies on the GOS-E. Patients requiring emergency extracranial surgery may warrant further investigation.

Indexed as

AnemiaBlood TransfusionBrain Injuries, TraumaticMultiple TraumaAdultFemaleGlasgow Outcome ScaleHumansInjury Severity ScoreMaleMiddle AgedQuality of LifeAnemiaExtracranial surgeryGlasgow outcome scale extendedMultiple traumaTransfusion strategyTraumatic brain injury

Identifiers

PMID41774107
PMCPMC12971814

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Registered trials

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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.