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1. Prevention of venous thromboembolism and haemostasis monitoring in patients with COVID-19: Updated proposals (April 2021): From the French working group on perioperative haemostasis (GIHP) and the French study group on thrombosis and haemostasis (GFHT), in collaboration with the French society of anaesthesia and intensive care (SFAR)

Author

Albaladejo, P., Blais, N., Bonhomme, F., Borel-Derlon, A., Cohen, A., Collet, J.-P., de Maistre, E., Fontana, P., Garrigue Huet, D., Godier, A., Gruel, Y., Godon, A., Ickx, B., Laporte, S., Lasne, D., Llau, J., Le Gal, G., Lecompte, T., Lessire, S., Levy, J.H., Longrois, D., Madi-Jebara, S., Mansour, A., Mazighi, M., Mismetti, P., Morange, P.E., Motte, S., Mullier, F., Nathan, N., Nguyen, P., Pernod, G., Rosencher, N., Roullet, S., Roy, P.M., Schlumberger, S., Sié, P., Steib, A., Susen, S., Tacquard, C.A., Testa, S., Vincentelli, A., Zufferey, P., Boissier, E, Dumont, B, James, C, Siguret, V., Godon, Alexandre, Tacquard, Charles Ambroise, Mansour, Alexandre, Garrigue, Delphine, Nguyen, Philippe, Lasne, Dominique, Testa, Sophie, Levy, Jerrold H., Albaladejo, Pierre, Gruel, Yves, Susen, Sophie, and Godier, Anne

Published
2021
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2. Gestion des agents antiplaquettaires en cas de procédure invasive non programmée ou d’hémorragie. Propositions du Groupe d’intérêt en hémostase périopératoire (GIHP) et du Groupe français d’études sur l’hémostase et la thrombose (GFHT) en collaboration avec la Société française d’anesthésie et de réanimation (SFAR)

Author

Belisle, S., Blais, N., Borel-Derlon, A., Borg, J.Y., Bosson, J.-L., Cohen, A., Faraoni, D., Garrigue Huet, D., Guay, J., Hardy, J.F., Huet, Y., Laporte, S., Levy, J.H., Llau, J., Le Gal, G., Lessire, S., Longrois, D., Madi-Jebara, S., Marret, E., Mas, J.L., Meyer, G., Mismetti, P., Morange, P.E., Motte, S., Mullier, F., Nathan, N., Ozier, Y., Pernod, G., Rosencher, N., Roullet, S., Roy, P.M., Samama, C.M., Schlumberger, S., Schved, J.F., Sié, P., Steib, A., Susen, S., van Belle, E., van Der Linden, P., Zufferey, P., Godier, Anne, Garrigue, Delphine, Lasne, Dominique, Fontana, Pierre, Bonhomme, Fanny, Collet, Jean-Philippe, de Maistre, Emmanuel, Ickx, Brigitte, Gruel, Yves, Mazighi, Mikael, Nguyen, Philippe, Vincentelli, André, Albaladejo, Pierre, and Lecompte, Thomas

Published
2019
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3. Management of antiplatelet therapy in patients undergoing elective invasive procedures. Proposals from the French Working Group on perioperative haemostasis (GIHP) and the French Study Group on thrombosis and haemostasis (GFHT). In collaboration with the French Society for Anaesthesia and Intensive Care Medicine (SFAR)

Author

Albaladejo, P., Belisle, S., Blais, N., Bonhomme, F., Borel-Derlon, A., Borg, J.Y., Bosson, J.-L., Cohen, A., Collet, J.-P., de Maistre, E., Faraoni, D., Fontana, P., Garrigue Huet, D., Godier, A., Gruel, Y., Guay, J., Hardy, J.F., Huet, Y., Ickx, B., Laporte, S., Lasne, D., Levy, J.H., Llau, J., Le Gal, G., Lecompte, T., Lessire, S., Longrois, D., Madi-Jebara, S., Marret, E., Mas, J.L., Mazighi, M., Mismetti, P., Morange, P.E., Motte, S., Mullier, F., Nathan, N., Nguyen, P., Ozier, Y., Pernod, G., Rosencher, N., Roullet, S., Roy, P.M., Samama, C.M., Schlumberger, S., Schved, J.F., Sié, P., Steib, A., Susen, S., van Belle, E., van Der Linden, P., Vincentelli, A., Zufferey, P., Godier, Anne, Fontana, Pierre, Motte, Serge, Steib, Annick, Bonhomme, Fanny, Schlumberger, Sylvie, Lecompte, Thomas, Rosencher, Nadia, Susen, Sophie, Vincentelli, André, Gruel, Yves, Albaladejo, Pierre, and Collet, Jean-Philippe

Published
2018
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4. Management of antiplatelet therapy in patients undergoing elective invasive procedures: Proposals from the French Working Group on perioperative hemostasis (GIHP) and the French Study Group on thrombosis and hemostasis (GFHT). In collaboration with the French Society for Anesthesia and Intensive Care (SFAR)

Author

Albaladejo, P., Belisle, S., Blais, N., Bonhomme, F., Borel-Derlon, A., Borg, J.Y., Bosson, J.-L., Cohen, A., Collet, J.-P., de Maistre, E., Faraoni, D., Fontana, P., Garrigue Huet, D., Godier, A., Gruel, Y., Guay, J., Hardy, J.F., Huet, Y., Ickx, B., Laporte, S., Lasne, D., Levy, J.H., Llau, J., Le Gal, G., Lecompte, T., Lessire, S., Longrois, D., Madi-Jebara, S., Marret, E., Mas, J.L., Mazighi, M., Mismetti, P., Morange, P.E., Motte, S., Mullier, F., Nathan, N., Nguyen, P., Ozier, Y., Pernod, G., Rosencher, N., Roullet, S., Roy, P.M., Samama, C.M., Schlumberger, S., Schved, J.F., Sié, P., Steib, A., Susen, S., van Belle, E., van Der Linden, P., Vincentelli, A., Zufferey, P., Godier, Anne, Fontana, Pierre, Motte, Serge, Steib, Annick, Bonhomme, Fanny, Schlumberger, Sylvie, Lecompte, Thomas, Rosencher, Nadia, Susen, Sophie, Vincentelli, André, Gruel, Yves, Albaladejo, Pierre, and Collet, Jean-Philippe

Published
2018
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5. Prevention of venous thromboembolism and haemostasis monitoring in patients with COVID-19: Updated proposals (April 2021)

Author

Godon, Alexandre, primary, Tacquard, Charles Ambroise, additional, Mansour, Alexandre, additional, Garrigue, Delphine, additional, Nguyen, Philippe, additional, Lasne, Dominique, additional, Testa, Sophie, additional, Levy, Jerrold H., additional, Albaladejo, Pierre, additional, Gruel, Yves, additional, Susen, Sophie, additional, Godier, Anne, additional, Albaladejo, P., additional, Blais, N., additional, Bonhomme, F., additional, Borel-Derlon, A., additional, Cohen, A., additional, Collet, J.-P., additional, de Maistre, E., additional, Fontana, P., additional, Garrigue Huet, D., additional, Godier, A., additional, Gruel, Y., additional, Godon, A., additional, Ickx, B., additional, Laporte, S., additional, Lasne, D., additional, Llau, J., additional, Le Gal, G., additional, Lecompte, T., additional, Lessire, S., additional, Levy, J.H., additional, Longrois, D., additional, Madi-Jebara, S., additional, Mansour, A., additional, Mazighi, M., additional, Mismetti, P., additional, Morange, P.E., additional, Motte, S., additional, Mullier, F., additional, Nathan, N., additional, Nguyen, P., additional, Pernod, G., additional, Rosencher, N., additional, Roullet, S., additional, Roy, P.M., additional, Schlumberger, S., additional, Sié, P., additional, Steib, A., additional, Susen, S., additional, Tacquard, C.A., additional, Testa, S., additional, Vincentelli, A., additional, Zufferey, P., additional, Boissier, E, additional, Dumont, B, additional, James, C, additional, and Siguret, V., additional

Published
2021
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6. Impact of High-Dose Prophylactic Anticoagulation in Critically Ill Patients With COVID-19 Pneumonia

Author

Tacquard, Charles, primary, Mansour, Alexandre, additional, Godon, Alexandre, additional, Godet, Julien, additional, Poissy, Julien, additional, Garrigue, Delphine, additional, Kipnis, Eric, additional, Rym Hamada, Sophie, additional, Mertes, Paul Michel, additional, Steib, Annick, additional, Ulliel-Roche, Mathilde, additional, Bouhemad, Bélaïd, additional, Nguyen, Maxime, additional, Reizine, Florian, additional, Gouin-Thibault, Isabelle, additional, Besse, Marie Charlotte, additional, Collercandy, Nived, additional, Mankikian, Stefan, additional, Levy, Jerrold H., additional, Gruel, Yves, additional, Albaladejo, Pierre, additional, Susen, Sophie, additional, Godier, Anne, additional, Albaladejo, P., additional, Blais, N., additional, Bonhomme, F., additional, Borel-Derlon, A., additional, Cohen, A., additional, Collet, J.-P., additional, de Maistre, E., additional, Fontana, P., additional, Garrigue Huet, D., additional, Godier, A., additional, Gruel, Y., additional, Godon, A., additional, Ickx, B., additional, Laporte, S., additional, Lasne, D., additional, Llau, J., additional, Le Gal, G., additional, Lecompte, T., additional, Lessire, S., additional, Levy, J.H., additional, Longrois, D., additional, Madi-Jebara, S., additional, Mansour, A., additional, Mazighi, M., additional, Mismetti, P., additional, Morange, P.E., additional, Motte, S., additional, Mullier, F., additional, Nathan, N., additional, Nguyen, P., additional, Pernod, G., additional, Rosencher, N., additional, Roullet, S., additional, Roy, P.M., additional, Schlumberger, S., additional, Sié, P., additional, Steib, A., additional, Susen, S., additional, Tacquard, C.A., additional, Testa, S., additional, Vincentelli, A., additional, and Zufferey, P., additional

Published
2021
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7. Gestion des agents antiplaquettaires en cas de procédure invasive non programmée ou d’hémorragie. Propositions du Groupe d’intérêt en hémostase périopératoire (GIHP) et du Groupe français d’études sur l’hémostase et la thrombose (GFHT) en collaboration avec la Société française d’anesthésie et de réanimation (SFAR)

Author

Godier, Anne, primary, Garrigue, Delphine, additional, Lasne, Dominique, additional, Fontana, Pierre, additional, Bonhomme, Fanny, additional, Collet, Jean-Philippe, additional, de Maistre, Emmanuel, additional, Ickx, Brigitte, additional, Gruel, Yves, additional, Mazighi, Mikael, additional, Nguyen, Philippe, additional, Vincentelli, André, additional, Albaladejo, Pierre, additional, Lecompte, Thomas, additional, Belisle, S., additional, Blais, N., additional, Borel-Derlon, A., additional, Borg, J.Y., additional, Bosson, J.-L., additional, Cohen, A., additional, Faraoni, D., additional, Garrigue Huet, D., additional, Guay, J., additional, Hardy, J.F., additional, Huet, Y., additional, Laporte, S., additional, Levy, J.H., additional, Llau, J., additional, Le Gal, G., additional, Lessire, S., additional, Longrois, D., additional, Madi-Jebara, S., additional, Marret, E., additional, Mas, J.L., additional, Meyer, G., additional, Mismetti, P., additional, Morange, P.E., additional, Motte, S., additional, Mullier, F., additional, Nathan, N., additional, Ozier, Y., additional, Pernod, G., additional, Rosencher, N., additional, Roullet, S., additional, Roy, P.M., additional, Samama, C.M., additional, Schlumberger, S., additional, Schved, J.F., additional, Sié, P., additional, Steib, A., additional, Susen, S., additional, van Belle, E., additional, van Der Linden, P., additional, and Zufferey, P., additional

Published
2019
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8. Management of antiplatelet therapy in patients undergoing elective invasive procedures. Proposals from the French Working Group on perioperative haemostasis (GIHP) and the French Study Group on thrombosis and haemostasis (GFHT). In collaboration with the French Society for Anaesthesia and Intensive Care Medicine (SFAR)

Author

Godier, Anne, primary, Fontana, Pierre, additional, Motte, Serge, additional, Steib, Annick, additional, Bonhomme, Fanny, additional, Schlumberger, Sylvie, additional, Lecompte, Thomas, additional, Rosencher, Nadia, additional, Susen, Sophie, additional, Vincentelli, André, additional, Gruel, Yves, additional, Albaladejo, Pierre, additional, Collet, Jean-Philippe, additional, Albaladejo, P., additional, Belisle, S., additional, Blais, N., additional, Bonhomme, F., additional, Borel-Derlon, A., additional, Borg, J.Y., additional, Bosson, J.-L., additional, Cohen, A., additional, Collet, J.-P., additional, de Maistre, E., additional, Faraoni, D., additional, Fontana, P., additional, Garrigue Huet, D., additional, Godier, A., additional, Gruel, Y., additional, Guay, J., additional, Hardy, J.F., additional, Huet, Y., additional, Ickx, B., additional, Laporte, S., additional, Lasne, D., additional, Levy, J.H., additional, Llau, J., additional, Le Gal, G., additional, Lecompte, T., additional, Lessire, S., additional, Longrois, D., additional, Madi-Jebara, S., additional, Marret, E., additional, Mas, J.L., additional, Mazighi, M., additional, Mismetti, P., additional, Morange, P.E., additional, Motte, S., additional, Mullier, F., additional, Nathan, N., additional, Nguyen, P., additional, Ozier, Y., additional, Pernod, G., additional, Rosencher, N., additional, Roullet, S., additional, Roy, P.M., additional, Samama, C.M., additional, Schlumberger, S., additional, Schved, J.F., additional, Sié, P., additional, Steib, A., additional, Susen, S., additional, van Belle, E., additional, van Der Linden, P., additional, Vincentelli, A., additional, and Zufferey, P., additional

Published
2018
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9. Management of antiplatelet therapy in patients undergoing elective invasive procedures: Proposals from the French Working Group on perioperative hemostasis (GIHP) and the French Study Group on thrombosis and hemostasis (GFHT). In collaboration with the French Society for Anesthesia and Intensive Care (SFAR)

Author

Godier, Anne, primary, Fontana, Pierre, additional, Motte, Serge, additional, Steib, Annick, additional, Bonhomme, Fanny, additional, Schlumberger, Sylvie, additional, Lecompte, Thomas, additional, Rosencher, Nadia, additional, Susen, Sophie, additional, Vincentelli, André, additional, Gruel, Yves, additional, Albaladejo, Pierre, additional, Collet, Jean-Philippe, additional, Albaladejo, P., additional, Belisle, S., additional, Blais, N., additional, Bonhomme, F., additional, Borel-Derlon, A., additional, Borg, J.Y., additional, Bosson, J.-L., additional, Cohen, A., additional, Collet, J.-P., additional, de Maistre, E., additional, Faraoni, D., additional, Fontana, P., additional, Garrigue Huet, D., additional, Godier, A., additional, Gruel, Y., additional, Guay, J., additional, Hardy, J.F., additional, Huet, Y., additional, Ickx, B., additional, Laporte, S., additional, Lasne, D., additional, Levy, J.H., additional, Llau, J., additional, Le Gal, G., additional, Lecompte, T., additional, Lessire, S., additional, Longrois, D., additional, Madi-Jebara, S., additional, Marret, E., additional, Mas, J.L., additional, Mazighi, M., additional, Mismetti, P., additional, Morange, P.E., additional, Motte, S., additional, Mullier, F., additional, Nathan, N., additional, Nguyen, P., additional, Ozier, Y., additional, Pernod, G., additional, Rosencher, N., additional, Roullet, S., additional, Roy, P.M., additional, Samama, C.M., additional, Schlumberger, S., additional, Schved, J.F., additional, Sié, P., additional, Steib, A., additional, Susen, S., additional, van Belle, E., additional, van Der Linden, P., additional, Vincentelli, A., additional, and Zufferey, P., additional

Published
2018
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10. Gestion des agents antiplaquettaires en cas de procédure invasive non programmée ou d’hémorragie. Propositions du Groupe d’intérêt en hémostase périopératoire (GIHP) et du Groupe français d’études sur l’hémostase et la thrombose (GFHT) en collaboration avec la Société française d’anesthésie et de réanimation (SFAR)

Author

Godier, Anne, Garrigue, Delphine, Lasne, Dominique, Fontana, Pierre, Bonhomme, Fanny, Collet, Jean-Philippe, de Maistre, Emmanuel, Ickx, Brigitte, Gruel, Yves, Mazighi, Mikael, Nguyen, Philippe, Vincentelli, André, Albaladejo, Pierre, Lecompte, Thomas, Belisle, S., Blais, N., Borel-Derlon, A., Borg, J.Y., Bosson, J.-L., Cohen, A., Faraoni, D., Garrigue Huet, D., Guay, J., Hardy, J.F., Huet, Y., Laporte, S., Levy, J.H., Llau, J., Le Gal, G., Lessire, S., Longrois, D., Madi-Jebara, S., Marret, E., Mas, J.L., Meyer, G., Mismetti, P., Morange, P.E., Motte, S., Mullier, F., Nathan, N., Ozier, Y., Pernod, G., Rosencher, N., Roullet, S., Roy, P.M., Samama, C.M., Schlumberger, S., Schved, J.F., Sié, P., Steib, A., Susen, S., van Belle, E., van Der Linden, P., and Zufferey, P.

Abstract

Le Groupe d’intérêt en hémostase périopératoire (GIHP) et le Groupe français d’études sur l’hémostase et la thrombose (GFHT) en collaboration avec la Société française d’anesthésie et de réanimation (SFAR) ont fait des propositions sur la gestion des agents antiplaquettaires (AAP) en cas de procédure invasive non programmée ou d’hémorragie. Ces propositions ont été discutées puis validées par un vote, elles font toutes l’objet d’un accord fort. La gestion des AAP en urgence nécessite de prendre en compte leurs caractéristiques pharmacocinétiques et pharmacodynamiques, d’évaluer l’affaiblissement de la compétence hémostatique liée aux AAP et le risque hémorragique qu’il entraîne. Les tests fonctionnels plaquettaires peuvent aider à cette évaluation. Lorsque le risque hémorragique lié aux AAP est susceptible d’aggraver le pronostic, la neutralisation des AAP doit être envisagée, en prenant en compte l’efficacité des moyens de neutralisation (qui sont limités pour le prasugrel et le ticagrelor) mais aussi les risques associés à ces moyens. Ceux-ci incluent la transfusion plaquettaire, à des doses adaptées à l’AAP considéré, et les agents hémostatiques (facteur VII activé recombinant et acide tranexamique). Pour les procédures invasives non programmées, le report de quelques jours, voire de quelques heures, doit être envisagé lorsqu’il ne compromet pas le pronostic vital ou fonctionnel du patient, jusqu’à élimination ou diminution suffisante de l’effet de l’AAP ou de son métabolite actif.

Published
2024
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13. Impact of High-Dose Prophylactic Anticoagulation in Critically Ill Patients With Coronavirus Disease 2019 Pneumonia

Author

Tacquard, Charles, Mansour, Alexandre, Godon, Alexandre, Godet, Julien, Poissy, Julien, Garrigue, Delphine, Kipnis, Eric, Rym Hamada, Sophie, Mertes, Paul Michel, Steib, Annick, Ulliel-Roche, Mathilde, Bouhemad, Bélaïd, Nguyen, Maxime, Reizine, Florian, Gouin-Thibault, Isabelle, Besse, Marie Charlotte, Collercandy, Nived, Mankikian, Stefan, Levy, Jerrold H., Gruel, Yves, Albaladejo, Pierre, Susen, Sophie, Godier, Anne, Albaladejo, P., Blais, N., Bonhomme, F., Borel-Derlon, A., Cohen, A., Collet, J.-P., de Maistre, E., Fontana, P., Garrigue Huet, D., Godier, A., Gruel, Y., Godon, A., Ickx, B., Laporte, S., Lasne, D., Llau, J., Le Gal, G., Lecompte, T., Lessire, S., Levy, J.H., Longrois, D., Madi-Jebara, S., Mansour, A., Mazighi, M., Mismetti, P., Morange, P.E., Motte, S., Mullier, F., Nathan, N., Nguyen, P., Pernod, G., Rosencher, N., Roullet, S., Roy, P.M., Schlumberger, S., Sié, P., Steib, A., Susen, S., Tacquard, C.A., Testa, S., Vincentelli, A., and Zufferey, P.

Abstract

Because of the high risk of thrombotic complications (TCs) during severe acute respiratory syndrome coronavirus 2 infection, several scientific societies have proposed to increase the dose of preventive anticoagulation, although arguments in favor of this strategy are inconsistent.

Published
2021
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14. Comparison of Injuries Associated With Electric Scooters, Motorbikes, and Bicycles in France, 2019-2022.

Author

James A, Harrois A, Abback PS, Moyer JD, Jeantrelle C, Hanouz JL, Boutonnet M, Geeraerts T, Godier A, Pottecher J, Garrigue-Huet D, Cotte J, Pasqueron J, Foucrier A, Gauss T, and Raux M

Subjects
Male, Humans, Adult, Female, Bicycling, Cohort Studies, France epidemiology, Off-Road Motor Vehicles, Brain Injuries, Traumatic
Abstract

Importance: Electric scooter (e-scooter) use is increasing in France and in many urban environments worldwide. Yet little is known about injuries associated with use of e-scooters., Objective: To describe characteristics and outcomes of major trauma involving e-scooters., Design, Setting, and Participants: A multicenter cohort study was conducted in France using the national major trauma registry between January 1, 2019, and December 20, 2022. All patients admitted to a participating major trauma center following a road traffic crash (RTC) involving an e-scooter, a bicycle, or a motorbike were included., Exposure: Included patients were compared according to the 3 mechanisms., Main Outcomes and Measures: The primary outcome was trauma severity as defined by the Injury Severity Score (ISS). Secondary outcomes included the trends of the number of patients per year, a comparison of the RTC epidemiologic factors, injury severity, resources used, and in-hospital outcomes., Results: A total of 5233 patients involved in RTCs were admitted (median age, 33 [IQR, 24-48] years; 4629 [88.5%] men; median ISS, 13 [IQR, 8-22]). The population included 229 e-scooter RTCs (4.4%), 4094 motorbike RTCs (78.2%), and 910 bicycle RTCs (17.4%). The number of patients treated following e-scooter RTCs increased by 2.8-fold in 4 years (from 31 in 2019 to 88 in 2022), while bicycle RTCs increased by 1.2-fold and motorbike RTCs decreased by 0.9-fold. At admission, 36.7% of e-scooter users had a blood alcohol content higher than the legal threshold (n = 84) and 22.5% wore a protective helmet (n = 32). Among e-scooter RTCs, 102 patients (45.5%) had an ISS of 16 or higher. This proportion was similar for patients with motorbike RTCs (1557 [39.7%]; P = .10) and bicycle RTCs (411 [47.3%]; P = .69). With a proportion of 25.9% (n = 50), patients with e-scooter RTCs had twice as many severe traumatic brain injuries (Glasgow Coma Scale ≤8) as motorbike RTCs (445 [11.8%]) and a proportion comparable to bicycle RTCs (174 [22.1%]). The mortality of e-scooter RTCs was 9.2% (n = 20), compared with 5.2% (n = 196) (P = .02) for motorbikes and 10.0% (n = 84) (P = .82) for bicycles., Conclusions and Relevance: The findings of this study suggest that trauma involving e-scooters in France has significantly increased over the past 4 years. These patients presented with injury profiles as severe as those of individuals who experienced bicycle or motorbike RTCs, with a higher proportion of severe traumatic brain injury.

Published
2023
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15. Association of Organizational Pathways With the Delay of Emergency Surgery.

Author

Lepercq D, Gauss T, Godier A, Bellet J, Bouhours G, Bouzat P, Cailliau E, Cook F, David JS, Drame F, Gauthier M, Lamblin A, Pottecher J, Tavernier B, and Garrigue-Huet D

Subjects
Male, Adult, Child, Humans, Middle Aged, Female, Cohort Studies, Prospective Studies, Tertiary Care Centers, Emergencies, Operating Rooms
Abstract

Importance: Delayed admission of patients with surgical emergencies to the operating room occurs frequently and is associated with poor outcomes. In France, where 3 distinct organizational pathways in hospitals exist (a dedicated emergency operating room and team [DET], a dedicated operating room in a central operating theater [DOR], and no dedicated structure or team [NOR]), neither the incidence nor the influence of delayed urgent surgery is known, and no guidelines are available to date., Objective: To examine the overall frequency of delayed admission of patients with surgical emergencies to the operating room across the 3 organizational pathways in hospitals in France., Design, Setting, and Participants: This prospective multicenter cohort study was conducted in 10 French tertiary hospitals. All consecutive adult patients admitted for emergency surgery from October 5 to 16, 2020, were included and prospectively monitored. Patients requiring pediatric surgery, obstetrics, interventional radiology, or endoscopic procedures were excluded., Exposures: Emergency surgery., Main Outcomes and Measures: The main outcome was the global incidence of delayed emergency surgery across 3 predefined organizational pathways: DET, DOR, and NOR. The ratio between the actual time to surgery (observed duration between surgical indication and incision) and the ideal time to surgery (predefined optimal duration between surgical indication and incision according to the Non-Elective Surgery Triage classification) was calculated for each patient. Surgery was considered delayed when this ratio was greater than 1., Results: A total of 1149 patients were included (mean [SD] age, 55 [21] years; 685 [59.9%] males): 649 in the DET group, 320 in the DOR group, and 171 in the NOR group (missing data: n = 5). The global frequency of surgical delay was 32.5% (95% CI, 29.8%-35.3%) and varied across the 3 organizational pathways: DET, 28.4% (95% CI, 24.8%-31.9%); DOR, 32.2% (95% CI, 27.0%-37.4%); and NOR, 49.1% (95% CI, 41.6%-56.7%) (P < .001). The adjusted odds ratio for delay was 1.80 (95% CI, 1.17-2.78) when comparing NOR with DET., Conclusions and Relevance: In this cohort study, the frequency of delayed emergency surgery in France was 32.5%. Reduced delays were found in organizational pathways that included dedicated theaters and teams. These preliminary results may pave the way for comprehensive large-scale studies, from which results may potentially inform new guidelines for quicker and safer access to emergency surgery.

Published
2023
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16. Comprehensive analysis of coagulation factor delivery strategies in a cohort of trauma patients.

Author

Roquet F, Godier A, Garrigue-Huet D, Hanouz JL, Vardon-Bounes F, Legros V, Pirracchio R, Ausset S, Duranteau J, Vigué B, and Hamada SR

Subjects
Adult, Humans, Blood Coagulation Factors therapeutic use, Hemorrhage therapy, Fibrinogen therapeutic use, Blood Transfusion, Blood Coagulation Disorders epidemiology, Blood Coagulation Disorders therapy, Hemostatics therapeutic use, Wounds and Injuries complications, Wounds and Injuries therapy
Abstract

Purpose: The 5 th edition of The European recommendations for the management of major bleeding and coagulopathy following trauma leaves room for various coagulation factor administration strategies. The present study examines these strategies reporting prevalence and timing of administration, quantity dispensed, and transfusion ratios in French trauma centers and their compliance with recommendations alongside associated mortality data., Methods: All adult patients, admitted directly to participating centers between 2011 and 2019, were extracted from a trauma registry. Two subpopulations were studied: severe hemorrhage (SH) and massive transfusion (MT) groups., Results: A total of 19,396 patients were included, among whom 8.4% (1630) experienced SH and 3% (579) received MT. Within the first 24 hours, 10% received fresh frozen plasma (FFP), rising to 93% and 99% in the subgroups of patients experiencing SH and MT respectively. Only, 8% received fibrinogen concentrate (FC), increasing to 75% and 92% in subgroups SH and MT respectively. Co-administration of FFP and FC became the dominant strategy with 68% of patients at 6 h and 72% at 24 h in SH subgroup. In unadjusted data, mortality was systematically lower in groups that complied with recommendations, a lower mortality than expected was mostly observed in contrast to non-compliant subgroups. The per-patient compliance to studied recommendations was 21% and 22% in SH and MT subgroups., Conclusion: The main hemostatic strategy for major bleeding combined the administration of both FFP and FC, favoring an early additional supply of fibrinogen. Compliance with the recommendations was low in SH and MT subgroups., (Copyright © 2022 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)

Published
2023
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17. Prothrombin Time ratio can predict mortality in severe pediatric trauma: Study in a French trauma center level 1.

Author

Hochart A, Momal R, Garrigue-Huet D, Drumez E, Susen S, and Bijok B

Subjects
Adolescent, Child, Child, Preschool, Female, France epidemiology, Humans, Infant, Male, Mortality trends, Pediatrics instrumentation, Pediatrics methods, Pediatrics trends, Prothrombin Time methods, Retrospective Studies, Trauma Centers organization & administration, Trauma Centers statistics & numerical data, Wounds and Injuries blood, Wounds and Injuries complications, Predictive Value of Tests, Prothrombin Time statistics & numerical data, Wounds and Injuries mortality
Abstract

Background: Injury results in more deaths in children than all other causes combined, but there is little data regarding the association of early coagulopathy on outcomes in pediatric patients with traumatic injuries. The aim of this study was to determine the optimal cut-off value for the Prothrombin Time ratio (PTr) and to show the diagnostic characteristics of the PTr to predict mortality., Methods: We retrospectively included during 4 years all patients less than 16 years old referred to our trauma center for traumatic injury with ISS ≥9., Results: A total of 272 children were included. Mean age was 9.4 ± 4.8 years and median ISS was 17 [interquartile range, 12 to 26]. Day 28 mortality was 6.7%. The optimal cut-off value in our population for predicting day 28 mortality was 1.24. Using this value, the sensitivity of PTr was 84%, specificity was 82%, positive likelihood ratio was 4.7, and negative likelihood ratio was 0.19. Early mortality (i.e., mortality at 24 h) was also well-predicted (1.0% versus 16.4%, p < .0001), as the need for massive transfuion. Similarly, patients with PTr ≥1.24 at admission presented with a higher rate of severe thoracic and abdominal trauma, higher ISS, higher likelihood of admission to an intensive care unit, longer hospitalization, and higher rate of significant procedure (e.g., surgery or embolization)., Conclusions: Trauma-induced coagulopathy defined only by a PTr ≥1.24 could be used as a severity predictive marker and as a sensitive, specific, quick, and easy to use tool for admission triage of pediatric patients., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Published
2020
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