Antifibrinolytic agent Tranexamic acid (TXA) has a possible clinical advantage for in-hospital patients with severe bleeding; however its efficacy in pre-hospital settings remains uncertain.
Traumatic bleeding to be the leading cause of early mortality in
injured patients. Based on the previous studies tranexamic acid (TXA) reported
to be efficiently controlling bleeding at early stage post trauma. But due to
lacking of published randomized control studies, its effectiveness in
pre-hospital settings remains unclear. Therefore, in the current research, it
was demonstrated that prehospital TXA appears to reduce early mortality in
trauma patients.
Antifibrinolytic agent Tranexamic acid (TXA) has a
possible clinical advantage for in-hospital patients with severe bleeding;
however its efficacy in pre-hospital settings remains uncertain. This
systematic review and meta-analysis assess whether pre-hospital administration
of TXA improved patients' outcomes compared to placebo?
Retrospective, randomised (RCT) or quasi-RCT, prospective studies
were searched from databases like Cochrane Library, Cochrane Central Register
of Controlled Trials (CENTRAL), WHO International Clinical Trials Registry
Platform, Google Scholar, MEDLINE, Scopus, PubMed, and clinicaltrials.gov to
compare impact of prehospital administration of TXA and placebo on the outcomes
of trauma patients with notable haemorrhage. In-hospital thromboembolic
complications and 24 hours 30-day mortality were taken as the main outcomes.
Data were abstracted independently by two authors by applying a data collection
form. When suitable, findings from several studies were pooled for the
analysis.
Two analytical studies matched the inclusion criteria. The impact of
TXA on 24-hour mortality had a pooled odds ratio (OR) of 0.49, 30-day mortality
OR of 0.86, and thromboembolic events OR of 0.74.
Prehospital TXA decreased early mortality among trauma patients.
Further randomised controlled clinical trials are required to evaluate the
significance of these outcomes.
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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