Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients

Article Article scientifique Méta-analyse Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients eng 2018 author Gayet-Ageron Angèle 668551 author Prieto-Merino David author Ker Katharine author Shakur Haleema author Ageron François-Xavier author Roberts Ian Gareth 22985 the Antifibrinolytic Trials Collaboration 125-132 10.1016/S0140-6736(17)32455-8 29126600 0140-6736 https://linkinghub.elsevier.com/retrieve/pii/S0140673617324558 Antifibrinolytics reduce death from bleeding in trauma and post-partum haemorrhage. We examined the effect of treatment delay on the effectiveness of antifibrinolytics. We did an individual patient-level data meta-analysis of randomised trials done with more than 1000 patients that assessed antifibrinolytics in acute severe bleeding. We identified trials done between Jan 1, 1946, and April 7, 2017, from MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, PubMed, Popline, and the WHO International Clinical Trials Registry Platform. The primary measure of treatment benefit was absence of death from bleeding. We examined the effect of treatment delay on treatment effectiveness using logistic regression models. We investigated the effect of measurement error (misclassification) in sensitivity analyses. This study is registered with PROSPERO, number 42016052155. Dewey 618 217 Centre de recherche clinique 201 false 88 Epidémiologie clinique 115 The Lancet 391 10116 de0240bf-3a08-4293-adf6-b36a03d0b7e4 Article (Published version) Public 1-s2.0-S0140673617324558-main.pdf 1263465 application/pdf CC BY-NC-ND 1ba34357-1ea5-463b-ab8c-11d5dbcca61a Supplemental data Public 1-s2.0-S0140673617324558-mmc1.pdf 378355 application/pdf openAccess Faculté de médecine / Centre de recherche clinique

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Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients	The Lancet			2018	374	221

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Roberts, Ian Gareth