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General Critical Care

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Tranexamic Acid for Traumatic Injury in the Emergency Setting

This study aimed to evaluate the effectiveness of tranexamic acid (TXA) in reducing mortality in emergency trauma cases. A systematic review and meta-analysis of randomized controlled trials were conducted, focusing on TXA's impact compared to a placebo. The main outcome was 1-month mortality. Seven trials met the criteria, and the results showed an 11% decrease in death risk at 1 month with TXA use. There was also a reduction in 24-hour mortality, and no significant increase in vascular occlusive events was observed.

Tranexamic Acid
Forest plot depicting estimated effects of each trial and the meta-analytic effect. Odd ratios indicate the odds of mortality with tranexamic acid compared to placebo at one month. CI, confidence interval.

Subgroup analyses indicated that TXA is more effective in general trauma than in traumatic brain injury and is more beneficial when administered out-of-hospital rather than in-hospital. The study concludes that TXA reduces 1-month mortality in emergency trauma cases without significant vascular complications, and its effectiveness varies depending on the type of trauma and the setting of administration.

Tranexamic acid should be routinely given to trauma patients including TBI if no contraindication

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Noor Shah
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