CRASH-2

OBJECTIVE: The purpose of this study was to investigate characteristics associated with farm vehicle and farm labor transportation-related roadway crashes. Agricultural roadway crashes related to farm vehicles and farm labor transportation have not been explored in Florida. METHODS: The data for this study comes from the Florida Department of Highway Safety and Motor Vehicles (FLHSMV) for the years 2013-2021. The data are recorded by the Florida Highway Patrol when a vehicular crash has occurred...

INTRODUCTION: We analyze and compare the factors that influence the fatality of pedestrian and bicyclist involved crashes in New Jersey using available police-reported crash data between 2016 and 2020. Under three percent of crashes involve non-motorists statewide, but these account for about one third of all traffic fatalities in the state. METHODS: Our analysis is broken down into five parts: we (1) analyze the relationship between minority and low-income communities and non-motorist involved crashes; (2) identify spatial differences between non-motorist involved crashes and non-motorist involved fatal crashes; (3) compare the factors affecting fatal pedestrian crashes in New Jersey and in four counties in southern New Jersey for which we have data on pedestrian infrastructure; (4) compare the factors affecting fatal pedestrian crashes and fatal cyclist crashes in New Jersey; and, (5) discuss priority areas for improving safety...

BACKGROUND: Construction projects are one of the most critical occupational sectors that experienced many challenges in occupational accidents and safety performance. OBJECTIVE: This study was designed to assess safety risk in construction projects based on fuzzy analytic hierarchy process. METHODS: This study was conducted with 12 construction and occupational safety experts in one of the largest construction projects in Tehran-Iran in 2020...

OBJECTIVE: Early administration of tranexamic acid (TXA) has been shown to save lives in trauma patients, and some U.S. emergency medical systems (EMS) have begun providing this therapy prehospital. Treatment protocols vary from state to state: Some offer TXA broadly to major trauma patients, others reserve it for patients meeting vital sign criteria, and still others defer TXA entirely pending a hospital evaluation. The purpose of this study is to compare the avoidable mortality achievable under each of these strategies, and to report on the various approaches used by EMS...

This study combined crash reports, land use, real-time traffic, and weather data to form an integrated database to analyze the severity of crashes taking place on rural highways. As the traffic cameras are placed at fixed locations, there is a wide range of measured distances between crashes and the selected nearest camera for extracting traffic variables. This may change the significance of traffic variables. For the first time, spacing was introduced as the distance around the detectors in which traffic characteristics are inferred to crashes...

In public road tests of autonomous vehicles in California, rear-end crashes have been the most common type of crash. Collision avoidance systems, such as autonomous emergency braking (AEB), have provided an effective way for autonomous vehicles to avoid collisions with the lead vehicle, but to avert false alarms, AEB tends to apply late and hard brake only if a collision becomes unavoidable. Automatic preventive braking (APB) is a new collision avoidance method used in Mobileye's Responsibility-Sensitive Safety (RSS) model that aims to reduce crashes with a milder brake and decreased impact on traffic flow, but APB's safety performance is inferior to that of AEB...

INTRODUCTION: Hemorrhage is responsible for up to 40% of all traumatic deaths. The seminal CRASH-2 trial demonstrated a reduction in overall mortality following early tranexamic acid (TXA) administration to bleeding trauma patients. Following publication of the trial results, TXA has been incorporated into many prehospital trauma protocols. However, the cost-effectiveness of widespread TXA adoption by EMS is unknown. OBJECTIVE: To estimate the cost-effectiveness of statewide implementation of a TXA protocol...

BACKGROUND: Women are less likely than men to receive some emergency treatments. This study examines whether the effect of tranexamic acid (TXA) on mortality in trauma patients varies by sex and whether the receipt of TXA by trauma patients varies by sex. METHODS: First, we conducted a sex-disaggregated analysis of data from the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage (CRASH)-2 and CRASH-3 trials. We used interaction tests to determine whether the treatment effect varied by sex...

BACKGROUND: The Clinical Randomisation of an Anti-fibrinolytic in Significant Hemorrhage-2 (CRASH-2) is the largest randomized control trial (RCT) examining circulatory resuscitation for trauma patients to date and concluded a statistically significant reduction in all-cause mortality in patients administered tranexamic acid (TXA) within 3 hours of injury. Since the publication of CRASH-2, significant geographical variance in the use of TXA for trauma patients exists. This study aims to assess TXA use for major trauma patients with hemorrhagic shock in Ireland after the publication of CRASH-2...

BACKGROUND: Trauma is a major cause of morbidity and mortality in older adults and will become more common as the population ages. Tranexamic acid (TXA) is a lysine analogue frequently used in the setting of significant trauma with hemorrhage. The aim of this study is to investigate the heterogeneity of treatment effect of TXA as it relates to patient age during trauma care. METHODS: We included patients from the CRASH-2 trial who were randomized within 3 h of injury...

BACKGROUND: In large multicentre trials in diverse settings, there is uncertainty about the need to adjust for centre variation in design and analysis. A key distinction is the difference between variation in outcome (independent of treatment) and variation in treatment effect. Through re-analysis of the CRASH-2 trial (2010), this study clarifies when and how to use multi-level models for multicentre studies with binary outcomes. METHODS: CRASH-2 randomised 20,127 trauma patients across 271 centres and 40 countries to either single-dose tranexamic acid or identical placebo, with all-cause death at 4 weeks the primary outcome...

Background: The COVID-19 pandemic resulted in nationwide social distancing and shelter-in-place orders meant to curb transmission of the SARS-CoV-2 virus. The effect of the pandemic on injury patterns has not been well described in the USA. The study objective is to determine the effect of the COVID-19 pandemic on the distribution and determinants of traumatic injuries. Methods: This retrospective multi-institutional cohort study included all hospital admissions for acute traumatic injury at six community level I trauma centers...

INTRODUCTION: Reducing the likelihood of freeway secondary crashes will provide significant safety, operational and environmental benefits. This paper presents a method for assessing the likelihood of freeway secondary crashes with Adaptive Signal Control Systems (ASCS) deployed on alternate routes that are typically used by diverted freeway traffic to avoid any delay or congestion due to a freeway primary crash. METHOD: The method includes four steps: (1) identification of secondary crashes, (2) verification of alternate routes, (3) assessment of the likelihood of secondary crashes for freeways with ASCS deployed on alternate routes and non-ASCS (i...

BACKGROUND: The CRASH-3 trial hypothesised that timely tranexamic acid (TXA) treatment might reduce deaths from intracranial bleeding after traumatic brain injury (TBI). To explore the mechanism of action of TXA in TBI, we examined the timing of its effect on death. METHODS: The CRASH-3 trial randomised 9202 patients within 3 h of injury with a GCS score ≤ 12 or intracranial bleeding on CT scan and no significant extracranial bleeding to receive TXA or placebo...

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BACKGROUND: Hemorrhage is a leading cause of death after trauma and childbirth. In response to severe hemorrhage, bleeding patients often receive transfusions of red blood cells, plasma, platelets, or other blood components. We examined risk factors for transfusion in acute severe bleeding in two trials of over 20,000 patients to better understand factors associated with transfusion likelihood. STUDY DESIGN AND METHODS: We conducted a cohort analysis of data from the CRASH-2 and WOMAN trials, two multinational trials that recruited patients with traumatic and postpartum hemorrhage, respectively...

Understanding the coagulation process is critical to developing treatments for trauma and coagulopathies. Clinical studies on tranexamic acid (TXA) have resulted in mixed reports on its efficacy in improving outcomes in trauma patients. The largest study, CRASH-2, reported that TXA improved outcomes in patients who received treatment prior to 3 hours after the injury, but worsened outcomes in patients who received treatment after 3 hours. No consensus has been reached about the mechanism behind the duality of these results...

Traumatic brain injury (TBI) often results in coagulopathy, which increases mortality risk. The clinical randomization of an antifibrinolytic in significant head injury (CRASH) -2 and CRASH-3 trials confirmed that tranexamic acid (TXA) was effective after trauma. Herein, we report a unique coagulation change in a patient with TBI given TXA after point-of-care assessment. Coagulation functions were impaired on admission. At 1 hour after TXA administration, clotting time was further prolonged in the extrinsic coagulation pathway but shortened in the intrinsic coagulation system...

OBJECTIVES: The CRASH-2 trial demonstrated that tranexamic acid (TXA) in adults with significant traumatic hemorrhage safely reduces mortality. Given that the CRASH-2 trial did not include U.S. sites, our objective was to evaluate patient characteristics, TXA dosing strategies, and the incidence of mortality and adverse events in adult trauma patients receiving TXA at a U.S. Level I trauma center in the post-CRASH-2 era. METHODS: We conducted a retrospective study that included patients aged 18 years or older who received TXA after an acute injury from July 2014 to June 2017...

Examining the spatial relationships among crashes of various severity levels is essential for gaining a better understanding of the severity distribution and potential contributing factors to collisions. However, relatively few scholars have focused on analyzing this type of data. Therefore, in this study, we utilized a new index, the colocation quotient, to measure the spatial associations among crashes of various severities that occurred in College Station, Texas. This new method has been widely used to define the colocation pattern of categorized data in various fields, but it has not yet been applied to crash severity data...