Impact of a prehospital discrimination between trauma patients with or without early acute coagulopathy of trauma and the need for damage control resuscitation: rationale and design of a multicenter randomized phase II trial.

Tonglet, Martin;D'Orio, Vincenzo;Moens, Didier;Lens, François-Xavier;Ghuysen, Alexandre;et.al.
(2019) Acta Chirurgica Belgica (Bilingual Edition) — Vol. 119, n° 2, p. 88-94 (2019)

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Authors
  • Tonglet, Martin
    Author
  • D'Orio, Vincenzo
    Author
  • Moens, Didier
    Author
  • Lens, François-Xavier
    Author
  • Thoma, MaximilienUCLouvain
    Author
  • Ghuysen, Alexandre
    Author
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Abstract
(en) BACKGROUND: The evidence of the Trauma Induced Coagulopathy Clinical Score (TICCS) accuracy has been evaluated in several studies but the potential effect of its use on patient outcomes needs to be evaluated. The primary objective of this study is to evaluate the impact on mortality of a prehospital discrimination between trauma patients with or without a potential need for damage control resuscitation. METHODS: The trial will be designed as randomized phase II clinical trial with comparison of the experimental protocol against the standard of care. The TICCS will be calculated on the site of injury for the patients of the intervention group and treatment will be guided by the TICCS value. Seven days mortality, 30 days mortality, global use of blood products and global hospital length-of-stay will be compared. DISCUSSION: Many data suggest that a very early flagging of trauma patients in need for DCR would be beneficial but this need to be proved. Do we improve our quality of care by an earlier diagnosis? Does a prehospital discrimination between trauma patients with or without a potential need for DCR has a positive impact?
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Tonglet, M., D’Orio, V., Moens, D., Lens, F.-X., Alves, J., Thoma, M., Kreps, B., Youatou Towo, P., Betz, R., Piazza, J., Szecel, J., Decoster B, G., Guillaume, M., Husson, E., Donneau, A. F., Poplavsky, J. L., Minon, J. M., & Ghuysen, A. (2019). Impact of a prehospital discrimination between trauma patients with or without early acute coagulopathy of trauma and the need for damage control resuscitation: rationale and design of a multicenter randomized phase II trial. Acta Chirurgica Belgica (Bilingual Edition), 119(2), 88-94. https://doi.org/10.1080/00015458.2018.1470276 (Original work published 2019)