The U.S. Department of Defense has awarded The University of Texas Health Science Center at Houston a $9.2 million grant to conduct a multi-center clinical trial that could lead to an improved survival rate for trauma patients – both soldiers and civilians -- who require massive blood transfusions.
The university's Center for Clinical and Translational Sciences (CCTS) is contracting with the U.S. Army Institute of Surgical Research to serve as the data coordination center for a Prospective, Observational, Multi-center Massive Transfusion Trial (PROMMTT). Clinical trial sites for the two-year study will include Memorial Hermann – Texas Medical Center and at least nine other trauma centers.
"Those first few hours after injury are critical, and we'll be looking at what happens minute-to-minute that determines whether these patients live or die," said Col. John Holcomb, M.D., co-investigator, director of the Center for Translational Injury Research (CeTIR) and professor in the Department of Surgery at The University of Texas Medical School at Houston.
"This has never been done before. With these data, we'll eventually be able to pinpoint what works and what doesn't, develop standards for transfusion ratios and greatly improve the mortality rate, which currently is as high as 40 to 70 percent, depending on the trauma center. We will be able to design prospective randomized trials with quality data," Holcomb said. "Finally, what we learn in the civilian population will also benefit the military."
From the time a trauma patient is admitted to the hospital to the time of discharge or death, healthcare providers will be logging data on vital signs, units of packed red blood cells, fresh frozen plasma and platelets, as well as medications and other healthcare information.
Jiajie Zhang, Ph.D., co-investigator, holder of the Dr. Doris L. Ross Professorship and the associate dean for research at The University of Texas School of Health Information Sciences at Houston, is leading the effort to design a secure, web-based informatics system that will make it possible to collect these data by the patient's bedside. The system also will allow for subsequent data management and analysis for clinical and translational research.
Mohammad Hossein Rahbar, Ph.D., director of the CCTS's Biostatistics, Epidemiology and Research Design (BERD) Component, is the principal investigator who will establish and manage the consortium of trauma centers and coordinate the data collection, data management and statistical analysis. Deborah Del Junco, Ph.D., associate professor at the CCTS-BERD, is among the co-investigators he will work with on the project.
"It is a very ambitious, meaningful project that draws upon the talents of those who are part of the CCTS," said Rahbar, who also holds a faculty appointment at The University of Texas School of Public Health. "The findings of this study could have long-term global implications, and it will set the stage for future studies."
Peter Davies, M.D., Ph.D., the university's executive vice president of research, said, "We are delighted with the success of Dr. Rahbar and his colleagues, particularly Dr. Del Junco, in competing for this very important award. It is an outstanding example of the ways that our grant to establish the CCTS is allowing us to transform clinical and translational research at our university. In addition, with the very recent recruitment of Dr. John Holcomb to our campus and the formation of the new Center for Translational Injury Research, this PROMMTT award can serve as the foundation for an enormously exciting program of trauma research at the UT Health Science Center at Houston."
Other UT Health Science Center at Houston faculty and staff who will be a part of PROMMTT include Kari Bloom, Melita Lindsey, Ruby Benjamin-Garner, Paula Knudson, Robert Nobles, MPH; Noriaki Aoki, M.D., Ph.D.; Orieji Illoh, M.D.; Rosemary Kozar, M.D., Ph.D.; Ernest Gonzalez, M.D.; and Jeannette Podbielski, RN.
CCTS is a collaboration among the UT Health Science Center at Houston, The University of Texas M. D. Anderson Cancer Center and the Memorial Hermann Healthcare System. It is funded with a five-year, $36 million Clinical and Translational Science Award from the National Institutes of Health.