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- Title
The application of a haemorrhage assessment tool in evaluating control of bleeding in a pilot trauma haemorrhage trial.
- Authors
Curry, N.; Foley, C.; Wong, H.; Mora, A.; Curnow, E.; Zarankaite, A.; Hodge, R.; Hopkins, V.; Deary, A.; Ray, J.; Moss, P.; Reed, M. J.; Kellett, S.; Davenport, R.; Stanworth, S.
- Abstract
Summary: Objectives: To determine whether it was feasible to use a haemorrhage assessment tool (HAT) within a trauma trial and whether the data obtained could differentiate patients who had achieved haemostasis. Background: Major haemorrhage is one of the leading causes of death worldwide, affecting 40% of trauma patients. Clinical trials evaluating haemostatic interventions often use transfusion outcomes as a primary endpoint. Transfusion is highly dependent on local practice, limiting its reliability as a robust, transferable endpoint. Methods: A five‐point HAT questionnaire was applied to participants enrolled into the EFIT‐1 trial. This RCT evaluated the feasibility of administering a 6 g fibrinogen concentrate to patients with severe trauma haemorrhage. Results: Of participants, 98% completed a HAT; 75% participants had 'achieved haemostasis' at the time of tool completion, as determined by clinical acumen alone. HAT scores were able to differentiate which participants required transfusion after 3 h. Of participants, 56% were transfused red blood cells when they scored 0–2, compared to 17% with HAT scores between 3 and 5. Conclusion: This study has confirmed the feasibility of using a HAT during the emergency care of patients suffering trauma haemorrhage, and future studies should be conducted to determine its value as an endpoint in haemostasis studies.
- Subjects
HEMORRHAGE; ERYTHROCYTES
- Publication
Transfusion Medicine, 2019, Vol 29, Issue 6, p454
- ISSN
0958-7578
- Publication type
Article
- DOI
10.1111/tme.12644