The "Death Diamond": Death beyond Trauma. Issue 7 (July 2019)
- Record Type:
- Journal Article
- Title:
- The "Death Diamond": Death beyond Trauma. Issue 7 (July 2019)
- Main Title:
- The "Death Diamond": Death beyond Trauma
- Authors:
- Farrell, Michael
Marconi, Thomas
Getchell, John
Green, Raymond
Cipolle, Mark
Sixta, Sherry - Abstract:
- Thromboelastography (TEG) has become a critical tool for the diagnosis, assessment, and management of hyperfibrinolysis and coagulopathy in trauma. In 2015, Chapman et al. of the Denver group coined the term "Death Diamond" (DD) to describe a TEG tracing identified in a unique trauma population. The DD was associated with a 100 per cent positive predictive value for mortality. Given the potential prognostic implications and resource savings associated with validating the DD as a marker of futile care, we sought to further evaluate DD outcomes. A retrospective review of 6850 TEGs, 34 patients (24 trauma and 10 nontrauma), displayed a DD tracing. Through invasive procedures and transfusions, nine DD tracing "normalized, " but, ultimately, this did not impact the outcome because the DD had a positive predictive value of 100 per cent for mortality in both populations. The median survival time in trauma patients was two hours compared with seven hours in nontrauma patients. Overall, this study further validates the predictive value of the DD in a trauma population while also serving as an assessment of the DD in a nontrauma population. Given these findings, a DD may prove to be an indicator of futile care. Further multicenter studies should be conducted to confirm these results.
- Is Part Of:
- American surgeon. Volume 85:Issue 7(2019)
- Journal:
- American surgeon
- Issue:
- Volume 85:Issue 7(2019)
- Issue Display:
- Volume 85, Issue 7 (2019)
- Year:
- 2019
- Volume:
- 85
- Issue:
- 7
- Issue Sort Value:
- 2019-0085-0007-0000
- Page Start:
- 757
- Page End:
- 760
- Publication Date:
- 2019-07
- Subjects:
- Surgery -- Periodicals
Surgery -- United States -- Periodicals
617.0973 - Journal URLs:
- https://journals.sagepub.com/home/asua ↗
http://www.sagepublications.com/ ↗ - DOI:
- 10.1177/000313481908500738 ↗
- Languages:
- English
- ISSNs:
- 0003-1348
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 13095.xml