The application of a haemorrhage assessment tool in evaluating control of bleeding in a pilot trauma haemorrhage trial

N. Curry*, C. Foley, H. Wong, A. Mora, E. Curnow, A. Zarankaite, R. Hodge, V. Hopkins, A. Deary, J. Ray, P. Moss, M. J. Reed, S. Kellett, R. Davenport, S. Stanworth

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)454-459
Number of pages6
JournalTransfusion Medicine
Volume29
Issue number6
Early online date3 Nov 2019
DOIs
Publication statusPublished - 1 Dec 2019

Keywords

  • haemorrhage asssessment tool
  • major haemorrhage
  • randomised controlled trial
  • trauma

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