TOPLINE:
Use of tranexamic acid in traumatic injury emergencies reduces mortality, with no significant increase in problematic vascular occlusive events.
METHODOLOGY:
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This systematic review and bias-adjusted meta-analysis reviewed seven randomized controlled trials that compared tranexamic acid with placebo in the emergency setting.
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Primary outcome was 1-month mortality.
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Secondary outcomes were 24-hour mortality and vascular occlusive events.
TAKEAWAY:
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Tranexamic acid led to an 11% reduction in 1-month mortality (odds ratio [OR], 0.89; 95% CI, 0.84-0.95).
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Tranexamic acid also reduced 24-hour mortality by 24% (OR, 0.76; 95% CI, 0.65-0.88).
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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:
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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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