Time is the enemy: Mortality in trauma patients with hemorrhage from torso injury occurs long before the “golden hour”

Alarhayem, Abdul Q.; Myers, John G.; Dent, Daniel L.; Liao, Lillian; Muir, Mark T.; Mueller, Deborah; Nicholson, Susannah E.; Cestero, Ramon F.; Johnson, Matthew T.; Stewart, Ronald M.; O’Keefe, Grant E.; Eastridge, Brian J.

doi:10.1016/j.amjsurg.2016.08.018

Cited by 171 publications

(145 citation statements)

References 24 publications

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“…All of the fabricated foams were in the appropriate range of T g 's which showed their potential uses in battlefields. In addition, many trauma research data suggest that early treatment of noncompressible hemorrhage within the first 30 min can significantly increase patient survival rate (Alarhayem et al, ; Kotwal et al, ). Thus, the rapid expansion profiles observed in our foams are promising for quick application of a hemostat to a bleed site.…”

Section: Discussionmentioning

confidence: 99%

Biodegradable shape memory polymer foams with appropriate thermal properties for hemostatic applications

Jang

Fletcher

Monroe

et al. 2020

J Biomedical Materials Res

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Shape memory polymer (SMP) foams are a promising material for hemostatic dressings due to their biocompatibility, high surface area, excellent shape recovery, and ability to quickly initiate blood clotting. Biodegradable SMP foams could eliminate the need for a secondary removal procedure of hemostatic material from the patients’ wound, further facilitating wound healing. In this study, we developed hydrolytically and oxidatively biodegradable SMP foams by reacting polyols (triethanolamine or glycerol) with 6‐aminocaproic acid or glycine to generate foaming monomers with degradable ester bonds. These monomers were used in foam synthesis to provide highly crosslinked SMP foam structures. The ester‐containing foams showed clinically relevant thermal properties that were comparable to controls and excellent shape recovery within eight min. Triethanolamine‐based ester‐containing foams showed interconnected porous structure along with increased mechanical strength. Faster hydrolytic and oxidative biodegradation rates were achieved in ester‐containing foams in comparison to controls. These biodegradable SMP foams with clinically applicable thermal properties possess great potential as an effective hemostatic device for use in hospitals or on battlefields.

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Section: Discussionmentioning

confidence: 99%

Biodegradable shape memory polymer foams with appropriate thermal properties for hemostatic applications

Jang

Fletcher

Monroe

et al. 2020

J Biomedical Materials Res

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show abstract

“…In these situations, every minute really does count. Even if those products are available in the blood bank, it often takes 30–40 minutes to prepare and deliver them to the bedside, during which a substantial percentage of bleeding patients will die . The standard can be met by providing all hospitals with WB.…”

mentioning

confidence: 99%

Get ready: whole blood is back and it's good for patients

Holcomb

Jenkins

2018

Transfusion

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“…This finding is problematic in light of the postulation that a decreased time between injury and definitive care improves trauma outcomes. The American College of Surgeons recommends that severely injured patients should ideally arrive at the ED within the 'golden hour' [18]. A study by Young also found that fewer unexpected deaths occurred among patients transferred directly to the trauma center, compared to those in the inter-hospital transport group.…”

Section: Diccussionmentioning

confidence: 94%

Mortality Reduction in Major Trauma Patients after Establishment of a Level I Trauma Center in Korea: A Single-Center Experience

Roh

Kim

Sung

et al. 2017

Journal of Trauma and Injury

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Purpose: Trauma systems have been shown to decrease injury-related mortality. The present study aimed to compare the mortality rates of patients with major trauma (injury severity score >15) treated before and after the establishment of a level I trauma center. Methods: During this 20-month study, participants were divided into pre-trauma center and trauma center groups, and trauma and injury severity score (TRISS) method was used to compare mortality rates during 10-month periods before and after the establishment of the trauma center (October 2013 to July 2014 vs. October 2014 to July 2015). Results: Of the 541 total participants, 278 (51.5%) visited after the establishment of the trauma center. The Z and W statistics indicated better outcomes in the trauma center group than in the pre-trauma center group (Z statistic, 2.635 vs. -0.700; W statistic, 4.640). The trauma center group also exhibited meaningful reductions in the time interval from the emergency department (ED) visit to emergency surgery (118.0 minutes vs. 142.5 minutes, p=0.020) and the interval from the ED visit to intensive care unit admission (202.0 minutes vs. 259.0 minutes, p=0.035) relative to the pre-trauma center group. Conclusions: The TRISS and multivariate analysis revealed significant improvements in survival rates in the trauma center group, compared to the pre-trauma center group.

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Time is the enemy: Mortality in trauma patients with hemorrhage from torso injury occurs long before the “golden hour”

Cited by 171 publications

References 24 publications

Biodegradable shape memory polymer foams with appropriate thermal properties for hemostatic applications

Biodegradable shape memory polymer foams with appropriate thermal properties for hemostatic applications

Get ready: whole blood is back and it's good for patients

Mortality Reduction in Major Trauma Patients after Establishment of a Level I Trauma Center in Korea: A Single-Center Experience

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