TACTIC

Trauma remains one of the world’s biggest contributors to the global burden of disease. Predominantly affecting young adults and children, 800,000 European injury related deaths were recorded in 2002. Outcomes for critically injured trauma patients remain poor with severe bleeding, brain injury and tissue damage being associated with high mortality and disability. Nearly half of all trauma fatalities result from haemorrhage, with many patients developing a clotting disorder (coagulaopthy) within minutes of injury or during their clinical care, that worsens bleeding and hampers emergency surgery. Current treatment of bleeding and coagulopathy is based on empirical ”blind” administration of blood products, with large variations in practice between trauma centres.

Important advances in care will only be made by a coordinated European national level approach that pulls discovery research into patients, into clinical guidelines and into national and global policy. “Targeted Action for Curing Trauma Induced Coagulopathy” (TACTIC) is a comprehensive programme of comparative clinical research that will deliver this quantum step in the global health care management of coagulopathic trauma patients, and potentially all patients with acute critical illness.

TACTIC will recruit patients from a network of trauma centres in Amsterdam, Cologne, Copenhagen, London, Oslo and Oxford to compare the effectiveness of different current practices across Europe. It will deliver universal guidelines for how coagulaopathy should be monitored and treated, enabling the individualised treatment of all critically bleeding patients, and and resolve barriers to the subsequent continental implementation of patient-matched targeted transfusion policy, which is expected to reduce trauma haemorrhage-related mortality by approximately ten percent, saving 30.000 lives per year as well as significantly reducing hospital and societal costs.