{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:04:39Z","timestamp":1789657479020,"version":"4.0.1"},"reference-count":16,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T00:00:00Z","timestamp":1742688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T00:00:00Z","timestamp":1742688000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R21HL128863"],"award-info":[{"award-number":["R21HL128863"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Life\u2010threatening hemorrhage (LTH) is a significant cause of mortality in pediatrics. Timing of mortality in children with LTH is important for future trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a secondary analysis of the prospective observational massive transfusion in children (MATIC) study, time\u2010to\u2010event analysis was performed to determine timing of death based on etiology of LTH and cause of death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 449 children with LTH; the etiologies of LTHs included trauma (46%), operative (34%), and medical (20%). The cause of death at 24\u2009h in the trauma group was 56% from hemorrhage and 42% from central nervous system (CNS) failure; in operative group it was 94% from hemorrhage and 6% CNS failure; in medical group it was 84% hemorrhage and 3% CNS failure. The median (interquartile range [IQR]) time to death (hours) varied by cause of death (hemorrhagic: 3.3 [1.0\u201310.3], CNS failure: 30.4 [9.0\u201363.6]). For traumatic LTH, 90% of hemorrhage\u2010related deaths occurred within 19\u2009h and 90% of CNS failure deaths occurred within 92\u2009h. For operative LTH, 90% of hemorrhage\u2010related deaths occurred within 5\u2009days and 90% of CNS failure deaths occurred within 28\u2009days. For medical LTH, 90% of hemorrhage\u2010related deaths occurred within 44\u2009h and 90% of CNS failure deaths occurred within 24\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In children, timing of death differs according to etiology of LTH and by cause of death. The choice of primary outcome for trials in children with LTH should consider these differences based on the etiology of LTH being studied.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.18144","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T01:40:22Z","timestamp":1742780422000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Analysis of time to death for children with life\u2010threatening hemorrhage from traumatic, surgical, and medical etiologies"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8611-9873","authenticated-orcid":false,"given":"Rachel P.","family":"Vaizer","sequence":"first","affiliation":[{"name":"Department of Pediatrics Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8561-8760","authenticated-orcid":false,"given":"Christine M.","family":"Leeper","sequence":"additional","affiliation":[{"name":"Trauma and Transfusion Medicine Research Center, Department of Surgery University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liling","family":"Lu","sequence":"additional","affiliation":[{"name":"Trauma and Transfusion Medicine Research Center, Department of Surgery University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra D.","family":"Josephson","sequence":"additional","affiliation":[{"name":"Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital  St. Petersburg Florida USA"},{"name":"Departments of Oncology and Pediatrics Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie C.","family":"Leonard","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6740-2758","authenticated-orcid":false,"given":"Mark H.","family":"Yazer","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua B.","family":"Brown","sequence":"additional","affiliation":[{"name":"Trauma and Transfusion Medicine Research Center, Department of Surgery University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1721-0541","authenticated-orcid":false,"given":"Philip C.","family":"Spinella","sequence":"additional","affiliation":[{"name":"Trauma and Transfusion Medicine Research Center, Department of Surgery University of Pittsburgh  Pittsburgh Pennsylvania 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