TY - JOUR
T1 - Infrastructure and clinical practice for the detection and management of trauma-associated haemorrhage and coagulopathy
AU - Driessen, A.
AU - Schäfer, N.
AU - Albrecht, V.
AU - Schenk, M.
AU - Fröhlich, M.
AU - Stürmer, E. K.
AU - Maegele, M.
AU - AUTHOR GROUP
AU - Johansson, Pär
AU - Ostrowski, Sisse Rye
AU - Tuovinen, Hannele
AU - Stensballe, Jakob
AU - Goslings, Johann Carel
AU - Juffermans, Nicole
AU - Balvers, Kirsten
AU - Gaarder, Christine
AU - Brohi, Karim
AU - Eaglestone, Simon
AU - Rourke, Claire
AU - Campbell, Helen
AU - Curry, Nicola
AU - Stanworth, Simon
AU - Maegele, Marc
AU - Stürmer, Ewa K.
AU - Schäfer, Nadine
AU - Driessen, Arne
AU - Orr, Adrian
AU - Schubert, Axel
PY - 2015
Y1 - 2015
N2 - Early detection and management of post-traumatic haemorrhage and coagulopathy have been associated with improved outcomes, but local infrastructures, logistics and clinical strategies may differ. To assess local differences in infrastructure, logistics and clinical management of trauma-associated haemorrhage and coagulopathy, we have conducted a web-based survey amongst the delegates to the 15th European Congress of Trauma and Emergency Surgery (ECTES) and the 2nd World Trauma (WT) Congress held in Frankfurt, Germany, 25-27 May 2014. 446/1,540 delegates completed the questionnaire yielding a response rate of 29 %. The majority specified to work as consultants/senior physicians (47.3 %) in general (36.1 %) or trauma/orthopaedic surgery (44.5 %) of level I (70 %) or level II (19 %) trauma centres. Clinical assessment (> 80 %) and standard coagulation assays (74.6 %) are the most frequently used strategies for early detection and monitoring of bleeding trauma patients with coagulopathy. Only 30 % of the respondents declared to use extended coagulation assays to better characterise the bleeding and coagulopathy prompted by more individualised treatment concepts. Most trauma centres (69 %) have implemented local protocols based on international and national guidelines using conventional blood products, e.g. packed red blood cell concentrates (93.3 %), fresh frozen plasma concentrates (93.3 %) and platelet concentrates (83 %), and antifibrinolytics (100 %). 89 % considered the continuous intake of anticoagulants including "new oral anticoagulants" and platelet inhibitors as an increasing threat to bleeding trauma patients. This study confirms differences in infrastructure, logistics and clinical practice for the detection and management of trauma-haemorrhage and trauma-associated coagulopathy amongst international centres. Ongoing work will focus on geographical differences
AB - Early detection and management of post-traumatic haemorrhage and coagulopathy have been associated with improved outcomes, but local infrastructures, logistics and clinical strategies may differ. To assess local differences in infrastructure, logistics and clinical management of trauma-associated haemorrhage and coagulopathy, we have conducted a web-based survey amongst the delegates to the 15th European Congress of Trauma and Emergency Surgery (ECTES) and the 2nd World Trauma (WT) Congress held in Frankfurt, Germany, 25-27 May 2014. 446/1,540 delegates completed the questionnaire yielding a response rate of 29 %. The majority specified to work as consultants/senior physicians (47.3 %) in general (36.1 %) or trauma/orthopaedic surgery (44.5 %) of level I (70 %) or level II (19 %) trauma centres. Clinical assessment (> 80 %) and standard coagulation assays (74.6 %) are the most frequently used strategies for early detection and monitoring of bleeding trauma patients with coagulopathy. Only 30 % of the respondents declared to use extended coagulation assays to better characterise the bleeding and coagulopathy prompted by more individualised treatment concepts. Most trauma centres (69 %) have implemented local protocols based on international and national guidelines using conventional blood products, e.g. packed red blood cell concentrates (93.3 %), fresh frozen plasma concentrates (93.3 %) and platelet concentrates (83 %), and antifibrinolytics (100 %). 89 % considered the continuous intake of anticoagulants including "new oral anticoagulants" and platelet inhibitors as an increasing threat to bleeding trauma patients. This study confirms differences in infrastructure, logistics and clinical practice for the detection and management of trauma-haemorrhage and trauma-associated coagulopathy amongst international centres. Ongoing work will focus on geographical differences
U2 - https://doi.org/10.1007/s00068-014-0455-y
DO - https://doi.org/10.1007/s00068-014-0455-y
M3 - Article
C2 - 26037989
SN - 1863-9933
VL - 41
SP - 413
EP - 420
JO - European journal of trauma and emergency surgery
JF - European journal of trauma and emergency surgery
IS - 4
ER -