Tranexamic Acid Cuts Trauma Deaths

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


  • 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.


  • 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).


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.”


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


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


The authors declared no conflict of interest.

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