Does Tranexamic Acid Administration Increase the Risk of Thromboembolism?

Introduction Hemorrhage following trauma is one of the leading causes of death worldwide. Venous thromboembolism (VTE) is a common complication of an increased coagulable state, and the risk of VTE following the administration of tranexamic acid (TXA), an antifibrinolytic agent, is still controversial. Our aim is to understand whether there is any association between the administration of TXA and the risk of VTE development. Methods A retrospective cohort study enrolled trauma patients presenting to a level 1 trauma center who received TXA at King Abdulaziz Medical City (KAMC), a tertiary hospital in Riyadh, Saudi Arabia, between 2016 and 2020. Variables included were patients' demographics, comorbidities, laboratory investigations, TXA's route of administration, date of administration, and dose. Finally, the development of VTE in the form of deep vein thrombosis (DVT) or PE and those who died were evaluated. Results A total of 361 adult trauma patients who received TXA were included in the study. Most were males (90.3%) with an average age of 33 years and had a normal BMI (43.3%). Nine patients (2.5%) developed DVT, one of whom died, and five patients (1.4%) developed PE, with no recorded deaths. Conclusion The risk of VTE following the administration of TXA remains controversial and yet to be clearly demonstrated. In this study, there was no significant association between TXA administration and the risk of developing VTE. More research with a larger sample size is needed to identify and recognize any significant risk factors for developing such a condition.