Effects of tranexamic acid treatment in severely and non‐severely injured trauma patients
Background Urgent treatment with tranexamic acid (TXA) reduces bleeding deaths but there is disagreement about which patients should be treated. We examine the effects of TXA treatment in severely and non‐severely injured trauma patients. Study Design and Methods We did an individual patient data me...
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| Veröffentlicht in: | Transfusion (Philadelphia, Pa.) Pa.), 2022-08, Vol.62 (S1), p.S151-S157 |
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| container_title | Transfusion (Philadelphia, Pa.) |
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| creator | Ageron, Francois‐Xavier Shakur‐Still, Haleema Roberts, Ian |
| description | Background
Urgent treatment with tranexamic acid (TXA) reduces bleeding deaths but there is disagreement about which patients should be treated. We examine the effects of TXA treatment in severely and non‐severely injured trauma patients.
Study Design and Methods
We did an individual patient data meta‐analysis of randomized trials with over 1000 trauma patients that assessed the effects of TXA on survival. We defined the severity of injury according to characteristics at first assessment: systolic blood pressure of less than 90 mm Hg and a heart rate greater than 120 beats per minute or Glasgow Coma Scale score of less than nine or any GCS with one or more fixed dilated pupils. The primary measure was survival on the day of the injury. We examined the effect of TXA on survival in severely and non‐severely injured patients and how these effects vary with the time from injury to treatment.
Results
We obtained data for 32,944 patients from two randomized trials. Tranexamic acid significantly increased survival on the day of the injury (OR = 1.22, 95% CI 1.11–1.34; p |
| doi_str_mv | 10.1111/trf.16954 |
| format | Article |
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Urgent treatment with tranexamic acid (TXA) reduces bleeding deaths but there is disagreement about which patients should be treated. We examine the effects of TXA treatment in severely and non‐severely injured trauma patients.
Study Design and Methods
We did an individual patient data meta‐analysis of randomized trials with over 1000 trauma patients that assessed the effects of TXA on survival. We defined the severity of injury according to characteristics at first assessment: systolic blood pressure of less than 90 mm Hg and a heart rate greater than 120 beats per minute or Glasgow Coma Scale score of less than nine or any GCS with one or more fixed dilated pupils. The primary measure was survival on the day of the injury. We examined the effect of TXA on survival in severely and non‐severely injured patients and how these effects vary with the time from injury to treatment.
Results
We obtained data for 32,944 patients from two randomized trials. Tranexamic acid significantly increased survival on the day of the injury (OR = 1.22, 95% CI 1.11–1.34; p < .01). The effect of tranexamic acid on survival in non‐severely injured patients (OR = 1.25, 1.03–1.50) was similar to that in severely injured patients (OR = 1.22, 1.09–1.37) with no significant heterogeneity (p = .87). In severely and non‐severely injured pateints, treatment within the first hour after injury was the most effective.
Discussion
Early tranexamic acid treatment improves survival in both severely and non‐severely injured trauma patients. Its use should not be restricted to the severely injured.</description><identifier>ISSN: 0041-1132</identifier><identifier>EISSN: 1537-2995</identifier><identifier>DOI: 10.1111/trf.16954</identifier><identifier>PMID: 35748686</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Acids ; Antifibrinolytic agents ; Antifibrinolytic Agents - therapeutic use ; blood management ; Blood pressure ; Clinical trials ; Glasgow Coma Scale ; Heart rate ; Hemorrhage - drug therapy ; hemostasis ; Heterogeneity ; Humans ; Injury prevention ; Patients ; Survival ; Tranexamic Acid - therapeutic use ; Trauma ; Wounds and Injuries - drug therapy</subject><ispartof>Transfusion (Philadelphia, Pa.), 2022-08, Vol.62 (S1), p.S151-S157</ispartof><rights>2022 The Authors. published by Wiley Periodicals LLC on behalf of AABB.</rights><rights>2022 The Authors. Transfusion published by Wiley Periodicals LLC on behalf of AABB.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3884-918f15098a83a303621edc7639b1f03fd25d9e8dd04a12975b7a68cc65dd34e53</citedby><cites>FETCH-LOGICAL-c3884-918f15098a83a303621edc7639b1f03fd25d9e8dd04a12975b7a68cc65dd34e53</cites><orcidid>0000-0003-0520-3619</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftrf.16954$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftrf.16954$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35748686$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ageron, Francois‐Xavier</creatorcontrib><creatorcontrib>Shakur‐Still, Haleema</creatorcontrib><creatorcontrib>Roberts, Ian</creatorcontrib><title>Effects of tranexamic acid treatment in severely and non‐severely injured trauma patients</title><title>Transfusion (Philadelphia, Pa.)</title><addtitle>Transfusion</addtitle><description>Background
Urgent treatment with tranexamic acid (TXA) reduces bleeding deaths but there is disagreement about which patients should be treated. We examine the effects of TXA treatment in severely and non‐severely injured trauma patients.
Study Design and Methods
We did an individual patient data meta‐analysis of randomized trials with over 1000 trauma patients that assessed the effects of TXA on survival. We defined the severity of injury according to characteristics at first assessment: systolic blood pressure of less than 90 mm Hg and a heart rate greater than 120 beats per minute or Glasgow Coma Scale score of less than nine or any GCS with one or more fixed dilated pupils. The primary measure was survival on the day of the injury. We examined the effect of TXA on survival in severely and non‐severely injured patients and how these effects vary with the time from injury to treatment.
Results
We obtained data for 32,944 patients from two randomized trials. Tranexamic acid significantly increased survival on the day of the injury (OR = 1.22, 95% CI 1.11–1.34; p < .01). The effect of tranexamic acid on survival in non‐severely injured patients (OR = 1.25, 1.03–1.50) was similar to that in severely injured patients (OR = 1.22, 1.09–1.37) with no significant heterogeneity (p = .87). In severely and non‐severely injured pateints, treatment within the first hour after injury was the most effective.
Discussion
Early tranexamic acid treatment improves survival in both severely and non‐severely injured trauma patients. Its use should not be restricted to the severely injured.</description><subject>Acids</subject><subject>Antifibrinolytic agents</subject><subject>Antifibrinolytic Agents - therapeutic use</subject><subject>blood management</subject><subject>Blood pressure</subject><subject>Clinical trials</subject><subject>Glasgow Coma Scale</subject><subject>Heart rate</subject><subject>Hemorrhage - drug therapy</subject><subject>hemostasis</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>Injury prevention</subject><subject>Patients</subject><subject>Survival</subject><subject>Tranexamic Acid - therapeutic use</subject><subject>Trauma</subject><subject>Wounds and Injuries - drug therapy</subject><issn>0041-1132</issn><issn>1537-2995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kM9KAzEQh4MotlYPvoAseNHDtslmk02OUloVCoLUk4clTSawZf_UZFftzUfwGX0SU1t7EMxlSPjmN5kPoXOChyScUevskHDJ0gPUJ4xmcSIlO0R9jFMSE0KTHjrxfokxTiQmx6hHWZYKLngfPU-sBd36qLFR61QN76oqdKR0YcIdVFtB3UZFHXl4BQflOlK1ieqm_vr43D8V9bJzsGlQXaWilWqL0OVP0ZFVpYezXR2gp-lkPr6LZw-39-ObWaypEGksibCEYSmUoIpiyhMCRmecygWxmFqTMCNBGINTRRKZsUWmuNCaM2NoCowO0NU2d-Walw58m1eF11CWYZ2m83nCBcE0CSMCevkHXTadq8PvAhUEpjQlPFDXW0q7xnsHNl-5olJunROcb4znwXj-YzywF7vEblGB2ZO_igMw2gJvRQnr_5Py-eN0G_kNMpKLLw</recordid><startdate>202208</startdate><enddate>202208</enddate><creator>Ageron, Francois‐Xavier</creator><creator>Shakur‐Still, Haleema</creator><creator>Roberts, Ian</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0520-3619</orcidid></search><sort><creationdate>202208</creationdate><title>Effects of tranexamic acid treatment in severely and non‐severely injured trauma patients</title><author>Ageron, Francois‐Xavier ; Shakur‐Still, Haleema ; Roberts, Ian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3884-918f15098a83a303621edc7639b1f03fd25d9e8dd04a12975b7a68cc65dd34e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acids</topic><topic>Antifibrinolytic agents</topic><topic>Antifibrinolytic Agents - therapeutic use</topic><topic>blood management</topic><topic>Blood pressure</topic><topic>Clinical trials</topic><topic>Glasgow Coma Scale</topic><topic>Heart rate</topic><topic>Hemorrhage - drug therapy</topic><topic>hemostasis</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>Injury prevention</topic><topic>Patients</topic><topic>Survival</topic><topic>Tranexamic Acid - therapeutic use</topic><topic>Trauma</topic><topic>Wounds and Injuries - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ageron, Francois‐Xavier</creatorcontrib><creatorcontrib>Shakur‐Still, Haleema</creatorcontrib><creatorcontrib>Roberts, Ian</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Transfusion (Philadelphia, Pa.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ageron, Francois‐Xavier</au><au>Shakur‐Still, Haleema</au><au>Roberts, Ian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of tranexamic acid treatment in severely and non‐severely injured trauma patients</atitle><jtitle>Transfusion (Philadelphia, Pa.)</jtitle><addtitle>Transfusion</addtitle><date>2022-08</date><risdate>2022</risdate><volume>62</volume><issue>S1</issue><spage>S151</spage><epage>S157</epage><pages>S151-S157</pages><issn>0041-1132</issn><eissn>1537-2995</eissn><abstract>Background
Urgent treatment with tranexamic acid (TXA) reduces bleeding deaths but there is disagreement about which patients should be treated. We examine the effects of TXA treatment in severely and non‐severely injured trauma patients.
Study Design and Methods
We did an individual patient data meta‐analysis of randomized trials with over 1000 trauma patients that assessed the effects of TXA on survival. We defined the severity of injury according to characteristics at first assessment: systolic blood pressure of less than 90 mm Hg and a heart rate greater than 120 beats per minute or Glasgow Coma Scale score of less than nine or any GCS with one or more fixed dilated pupils. The primary measure was survival on the day of the injury. We examined the effect of TXA on survival in severely and non‐severely injured patients and how these effects vary with the time from injury to treatment.
Results
We obtained data for 32,944 patients from two randomized trials. Tranexamic acid significantly increased survival on the day of the injury (OR = 1.22, 95% CI 1.11–1.34; p < .01). The effect of tranexamic acid on survival in non‐severely injured patients (OR = 1.25, 1.03–1.50) was similar to that in severely injured patients (OR = 1.22, 1.09–1.37) with no significant heterogeneity (p = .87). In severely and non‐severely injured pateints, treatment within the first hour after injury was the most effective.
Discussion
Early tranexamic acid treatment improves survival in both severely and non‐severely injured trauma patients. Its use should not be restricted to the severely injured.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>35748686</pmid><doi>10.1111/trf.16954</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0520-3619</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Transfusion (Philadelphia, Pa.), 2022-08, Vol.62 (S1), p.S151-S157 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Acids Antifibrinolytic agents Antifibrinolytic Agents - therapeutic use blood management Blood pressure Clinical trials Glasgow Coma Scale Heart rate Hemorrhage - drug therapy hemostasis Heterogeneity Humans Injury prevention Patients Survival Tranexamic Acid - therapeutic use Trauma Wounds and Injuries - drug therapy |
| title | Effects of tranexamic acid treatment in severely and non‐severely injured trauma patients |
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