UK-REBOAJAMA 2023
Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial.
REBOA did not reduce mortality; the Bayesian analysis showed a high probability of harm, with more deaths, many occurring early from bleeding.
Randomised trialManagementMajor trauma & polytrauma
Major trauma networks (England)EClinicalMedicine 2018
Changing the System - Major Trauma Patients and Their Outcomes in the NHS (England) 2008-17.
After network implementation there were improvements in risk-adjusted odds of survival, faster senior care and CT, and more patients treated in major trauma centres.
Registry studyPrognosisMajor trauma & polytrauma
REACT-2Lancet (London, England) 2016
Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial.
Immediate total-body CT did not significantly reduce in-hospital mortality compared with a standard imaging approach.
Randomised trialDiagnosisMajor trauma & polytrauma
PROPPRJAMA 2015
Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial.
There was no significant difference in 24-hour or 30-day mortality, but the 1:1:1 group achieved haemostasis more often and had fewer deaths from exsanguination in the first 24 hours, without more complications.
Randomised trialManagementMajor trauma & polytrauma
CRASH-2 timing analysisLancet (London, England) 2011
The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial.
Treatment within 1 hour, and between 1 and 3 hours, significantly reduced bleeding deaths, whereas treatment after 3 hours appeared to increase the risk of death from bleeding.
Randomised trialManagementMajor trauma & polytrauma
LEAPThe New England journal of medicine 2002
An analysis of outcomes of reconstruction or amputation after leg-threatening injuries.
Functional outcomes at 2 years were similar after salvage and amputation, with substantial disability in both groups. Poor outcome was linked to complications needing readmission and to social and economic factors rather than treatment choice, and reconstruction carried a higher rehospitalisation rate.
Cohort studyPrognosisMajor trauma & polytrauma
Damage control orthopaedics (Scalea)The Journal of trauma 2000
External fixation as a bridge to intramedullary nailing for patients with multiple injuries and with femur fractures: damage control orthopedics.
Patients managed with external fixation were more severely injured, yet the staged approach was safe with low conversion complication rates, supporting its use in unstable patients.
Cohort studyManagementMajor trauma & polytrauma
Gustilo-Anderson classificationThe Journal of bone and joint surgery. American volume 1976
Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses.
Introduced the Gustilo-Anderson classification (types I to III) and showed infection risk rose with severity of soft tissue injury, supporting prophylactic antibiotics and leaving severe wounds open.
Cohort studyDiagnosisMajor trauma & polytrauma