Outcome criteria such as massive transfusion are inadequate for matching and result in questionable conclusions

摘要

We read with interest the recent publication by Wafaisade et al.1 The reported association between fibrinogen and increased multiple-organ failure plus the lack of decrease in overall mortality may' lead clinicians to question the use of fibrinogen concentrate for hemostatic therapy in trauma patients. However, there are significant methodological issues with thestudy, so we would urge caution when interpreting the results; "confounding by indication" is likely to have occurred.