Prognostic model for traumatic death due to bleeding: cross-sectional international study.

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State: Public
Version: author
License: CC BY-NC 4.0
Serval ID
serval:BIB_C7DF89C71C9D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prognostic model for traumatic death due to bleeding: cross-sectional international study.
Journal
BMJ open
Author(s)
Ageron F.X., Gayet-Ageron A., Steyerberg E., Bouzat P., Roberts I.
ISSN
2044-6055 (Electronic)
ISSN-L
2044-6055
Publication state
Published
Issued date
28/05/2019
Peer-reviewed
Oui
Volume
9
Number
5
Pages
e026823
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
To develop and validate a prognostic model and a simple model to predict death due to bleeding in trauma patients.
Cross-sectional study with multivariable logistic regression using data from two large trauma cohorts.
274 hospitals from 40 countries in the Clinical Randomisation of Anti-fibrinolytic in Significant Haemorrhage (CRASH-2) trial and 24 hospitals in the Northern French Alps Trauma registry.
13 485 trauma patients in the CRASH-2 trial and 9945 patients in the Northern French Alps Trauma registry who were admitted to hospital within 3 hours of injury.
In-hospital death due to bleeding within 28 days.
There were 815 (6%) deaths from bleeding in the CRASH-2 trial and 102 (1%) in the Northern French Alps Trauma registry. The full model included age, systolic blood pressure (SBP), Glasgow Coma Scale (GCS), heart rate, respiratory rate and type of injury (penetrating). The simple model included age, SBP and GCS. In a cross-validation procedure by country, discrimination and calibration were adequate (pooled C-statistic 0.85 (95% CI 0.81 to 0.88) for the full model and 0.84 (95% CI 0.80 to 0.88) for the simple model).
This prognostic model can identify trauma patients at risk of death due to bleeding in a wide range of settings and can support prehospital triage and trauma audit, including audit of tranexamic acid use.
Keywords
audit, bleeding, coagulopathy, death, haemorrhage, human, injury, prognostic, score, trauma
Pubmed
Web of science
Open Access
Yes
Create date
20/02/2020 11:30
Last modification date
15/01/2021 7:24
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