Observational studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Incidence of ROTEM
Observational study in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03572309 (Incidence of Trauma Induced Coagulopathy in Patients With Prehospital Administration of Fibrinogen), which is not on this map. Not yet cited in PubMed.
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Incidence of Trauma Induced Coagulopathy in Patients With Prehospital Administration of Fibrinogen
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8 authors.
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Abstract
purposeTrauma-induced coagulopathy affects approximately one-quarter of polytrauma patients and is associated with increased mortality. Given the central role of fibrinogen and its early depletion after injury, supplementation is recommended after hospital admission in the presence of hypofibrinogenaemia or suspected major haemorrhage. As coagulopathy develops within minutes of trauma, prehospital fibrinogen administration may help mitigate its progression before hospital arrival. This study evaluated the incidence of coagulopathy at hospital admission, assessed using ROTEM®, among polytrauma patients receiving fibrinogen concentrate in the prehospital setting.
methodsIn this single-centre, prospective observational study, adult patients with polytrauma (Injury Severity Score ≥ 16) were enrolled after prehospital administration of fibrinogen concentrate. The primary outcome was the presence of coagulopathy at hospital arrival, defined according to predefined ROTEM® Delta thresholds (FIBTEM MCF ≤ 8 mm and/or EXTEM CT ≥ 80 s and/or EXTEM MCF ≤ 49 mm). The secondary outcomes were laboratory coagulation status, 28-day all-cause mortality, and thromboembolic complications.
resultsThirty patients were enrolled, of whom 28 were included in the final analysis. Twenty-seven patients received 4 g of fibrinogen concentrate and one received 2 g due to short transport time. ROTEM®-defined coagulopathy was identified in two patients (7.1%), both based on EXTEM abnormalities; no patient had reduced FIBTEM MCF. Five patients (17.9%) died within 28 days and two patients (7.1%) experienced thromboembolic complications.
conclusionsOur findings describe a low incidence of ROTEM®-defined coagulopathy at hospital arrival in polytrauma patients who received prehospital fibrinogen concentrate. Adequately powered randomized controlled trials are required to determine whether prehospital fibrinogen administration reduces coagulopathy and improves clinically relevant outcomes.
trial registrationNCT03572309, ClinicalTrials.gov, registered on 19 June 2018.
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