Tranexamic Acid Cuts Trauma Deaths

TOPLINE:
Use of tranexamic acid in traumatic injury emergencies reduces mortality, with no significant increase in problematic vascular occlusive events.

METHODOLOGY:

  • This systematic review and bias-adjusted meta-analysis reviewed seven randomized controlled trials that compared tranexamic acid with placebo in the emergency setting.

  • Primary outcome was 1-month mortality.

  • Secondary outcomes were 24-hour mortality and vascular occlusive events.

TAKEAWAY:

  • Tranexamic acid led to an 11% reduction in 1-month mortality (odds ratio [OR], 0.89; 95% CI, 0.84-0.95).

  • Tranexamic acid also reduced 24-hour mortality by 24% (OR, 0.76; 95% CI, 0.65-0.88).

  • Tranexamic acid did not increase the risk for vascular occlusive events (OR, 0.96; 95% CI, 0.73-1.27).

IN PRACTICE:

According to the study authors, “despite the relatively small improvement, clinicians may consider even a slight enhancement to be significant from a clinical perspective, especially in patients with severe injuries, such as trauma and brain injuries.”

SOURCE:

The study, with the first author Pieter Francsois Fouche, MScMed (ClinEpi), PhD, was published online on November 22 in the Annals of Emergency Medicine.

LIMITATIONS:

  • Patient-centered outcomes like favorable neurological reporting were not reported in the included trials.

DISCLOSURES:

The authors declared no conflict of interest.

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