Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Introduction: Haemorrhage causes most preventable prehospital trauma deaths and about a third of in-hospital trauma deaths. Tranexamic acid (TXA), administered soon after hospital arrival in certain trauma systems, is an effective therapy in preventing or managing acute traumatic coagulopathy. However, delayed administration of TXA appears to be ineffective or harmful. The effectiveness of prehospital TXA, incidence of thrombotic complications, benefit versus risk in advanced trauma systems and the mechanism of benefit remain uncertain.
Methods And Analysis: The Pre-hospital Anti-fibrinolytics for Traumatic Coagulopathy and Haemorrhage (The PATCH-Trauma study) is comparing TXA, initiated prehospital and continued in hospital over 8 hours, with placebo in patients with severe trauma at risk of acute traumatic coagulopathy. We present the trial protocol and an overview of the statistical analysis plan. There will be 1316 patients recruited by prehospital clinicians in Australia, New Zealand and Germany. The primary outcome will be the eight-level Glasgow Outcome Scale Extended (GOSE) at 6 months after injury, dichotomised to favourable (GOSE 5-8) and unfavourable (GOSE 1-4) outcomes, analysed using an intention-to-treat (ITT) approach. Secondary outcomes will include mortality at hospital discharge and at 6 months, blood product usage, quality of life and the incidence of predefined adverse events.
Ethics And Dissemination: The study was approved by The Alfred Hospital Research and Ethics Committee in Victoria and also approved in New South Wales, Queensland, South Australia, Tasmania and the Northern Territory. In New Zealand, Northern A Health and Disability Ethics Committee provided approval. In Germany, Witten/Herdecke University has provided ethics approval. The PATCH-Trauma study aims to provide definitive evidence of the effectiveness of prehospital TXA, when used in conjunction with current advanced trauma care, in improving outcomes after severe injury.
Trial Registration Number: NCT02187120.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7970250 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2020-046522 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
[Disseminated intravascular coagulation in critical obstetrical hemorrhage and severe trauma].
Rinsho Ketsueki
September 2025
Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine.
Disseminated intravascular coagulation (DIC) associated with critical obstetrical hemorrhage and severe trauma is classified as fibrinolytic DIC in terms of pathology and acute DIC in terms of progression. Obstetrical DIC is triggered by the influx of tissue factors from the placenta, amniotic fluid, and decidua into the maternal circulation. In contrast, trauma-related DIC is caused by vascular endothelial damage and exposure of subendothelial tissue.
View Article and Find Full Text PDF[Primary multiple hypertensive intracerebral hemorrhages].
Zh Nevrol Psikhiatr Im S S Korsakova
September 2025
Prof. V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia.
Non-traumatic intracerebral hemorrhages of multiple localization are most often associated with coagulopathies, uncontrolled use of anticoagulants, vasculitis, thrombosis of venous sinuses, amyloid angiopathy, and other conditions. If secondary risk factors cannot be identified, such hemorrhages are regarded as primary multiple due to hypertension. Their pathogenesis is poorly studied, with most researchers suggesting a sequential rupture of blood vessels when the first hemorrhage contributes to developing another one through increasing intracranial and blood pressure.
View Article and Find Full Text PDFAn Analysis of the Presence of Coagulopathy on Arrival to Emergency Departments in Deployed Military Treatment Facilities.
Mil Med
August 2025
Center for Combat and Battlefield (COMBAT) Research, University of Colorado School of Medicine, Aurora, CO 80045, United States.
Introduction: Acute traumatic coagulopathy remains a high predictor of mortality; however, the incidence and outcomes in the military population have limited data. The goal of our study is to characterize coagulopathy on arrival to deployed Role 2 and Role 3 Military Treatment Facilities (MTFs).
Materials And Methods: We utilized the Department of Defense Trauma Registry to identify United States (U.
Integrating Peripheral Nerve Blocks in Multiple Trauma Care: Current Evidence and Clinical Challenges.
J Clin Med
August 2025
Faculty of Medicine, "Carol-Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Pain management in multiple trauma patients presents a complex clinical challenge due to competing priorities such as hemodynamic instability, polypharmacy, coagulopathy, and the urgency of life-saving interventions. In this context, peripheral nerve blocks (PNBs) are increasingly recognized as a valuable asset for their role in managing pain in patients with multiple traumatic injuries. By reducing reliance on systemic opioids, PNBs support effective pain control and facilitate early mobilization, aligning with enhanced recovery principles.
View Article and Find Full Text PDFSkull fractures may be associated with hyperfibrinolysis in patients with isolated traumatic brain injury.
Clin Exp Emerg Med
August 2025
Department of Critical and Intensive Care Medicine, Shiga University of Medical Science, Setatsukinowacho, Otsu, Shiga, Japan.
Objectives: To identify the association between skull fracture (SF) and hyperfibrinolysis (HF) among patients with isolated traumatic brain injury.
Methods: This study was the retrospective cohort study based on the nationwide neurotrauma database in Japan. Adult patients with isolated traumatic brain injury (head abbreviated injury scale (AIS) >2, any other AIS <3) registered in the JNTDB from 2015 to 2017 were included.