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Pre-hospital use of TXA reduced the risk of thromboembolic events
and 30 days mortality rate; high quality RCTs should be conducted to promote
its routine use in trauma patients.
According to a recent study published in “The American Journal of Emergency Medicine”, a significant reduction in early mortality was observed with prehospital administration of Tranexamic acid (TXA) in trauma patients.
Previous scientific evidence reports traumatic bleeding to be the leading cause of early mortality in injured patients. Acute coagulopathy is a common complication in around 25% of the trauma patients, and about 40% of them have died due to hemorrhagic shock. Recent studies demonstrated that early treatment of acute coagulopathies and hemorrhagic shock considerably minimizes post-traumatic deaths. TXA is a cost-effective antifibrinolytic agent, and it has shown a significant reduction in mortality in patients with trauma-induced hemorrhagic shock. Therefore Ayman El-Menyar et al. conducted the present systematic review and meta-analysis to evaluate if pre-hospital administration of TXA improves patients’ outcomes in comparison to placebo.
The number of retrospectives, prospective and randomized (RCT) or quasi-RCT studies conducted on the TXA in patients with trauma with significant haemorrhage were collected from the various search engines such as PubMed, MEDLINE, Cochrane Library, etc. The primary outcomes observed were 24 hour 30-day mortality and in-hospital thromboembolic complications. Data were extracted independently by two authors using a data collection form. They pooled the results from different studies for the analysis.
Out of 92 studies, only two analytical studies met the inclusion
criteria. The effect of TXA on 24-hour mortality had a pooled odds ratio (OR)
of 0.49 (95% CI 0.28–0.85), 30-day mortality OR of 0.86 (95% CI, 0.56–1.32),
and thromboembolic events OR of 0.74 (95% CI, 0.27–2.07). Overall TXA appears
to reduce the risk of thromboembolic events and mortality in trauma patients.
The American Journal of Emergency Medicine
Efficacy of prehospital administration of tranexamic acid in trauma patients: A meta-analysis of the randomized controlled trials
Ayman El-Menyar et al.
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