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Breakthrough by London doctors leads to huge fall in patients bleeding to death

The four-hour A&E target in hospitals is reportedly set to be scrapped within a year: Peter Byrne/PA
The four-hour A&E target in hospitals is reportedly set to be scrapped within a year: Peter Byrne/PA

The number of victims of major trauma who bleed to death has fallen 40 per cent in a decade after a breakthrough by London doctors.

Mortality rates for the most critically ill trauma patients at The Royal London Hospital, Whitechapel, have fallen from 47 per cent to 27 per cent.

The hospital is one of London’s four major trauma centres and treats about 150 “code red” critically bleeding patients a year — including victims of knife crime.

It worked with NHS Blood and Transplant and researchers at Queen Mary University of London to understand what happens to the body in the first minutes after injury.

Royal London in Whitechapel (Getty Images)
Royal London in Whitechapel (Getty Images)

Medics developed a dramatically different approach to resuscitating bleeding patients — they stopped giving large volumes of clear fluids and instead used blood products and clotting agents.

The mixture enabled the patient’s blood to clot and prevented the body’s natural clotting systems from breaking down.

Results published today in the Annals of Surgery journal reveal the mortality rate fell from 47 per cent (55 out of 117 patients) in 2009 to 27 per cent (37 out of 137) in 2017. It meant that 771 of 1,169 patients who received at least one unit of the blood products survived.

About 27 patients a year who would previously have died at The Royal London now survive — as do many more in other major trauma centres, as the approach is adopted across the NHS.

The study’s lead author Dr Elaine Cole, of QMUL, said: “Changes in transfusion and resuscitation practice for traumatically injured patients has led to remarkable improvements in survival.”

Co-author Karim Brohi, consultant trauma surgeon at The Royal London and professor of trauma sciences at QMUL, said the aim was now to reduce mortality from severe bleeding to 10 per cent over the next decade.

Professor Brohi said: “We have reduced deaths by nearly half, which is an incredible achievement.

"We discovered that there is something about being injured which destroys the body’s ability to clot properly.

"Previously the [transfused] blood or fluid didn’t contain clotting factors and meant that people would start off with a problem and we would make it worse.”

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