No improvement seen in favorable functional outcome at six months, but reduced risk of death at 28 days after injury
By Elana Gotkine HealthDay Reporter
THURSDAY, June 15, 2023 (HealthDay News) — For adults with major trauma at risk for trauma-induced coagulopathy, tranexamic acid administered before hospital admission is not associated with improvement in favorable functional outcome at six months, according to a study published online June 14 in the New England Journal of Medicine to coincide with the annual Critical Care Reviews Meeting, held from June 14 to 16 in Belfast, Ireland.
Russell L. Gruen, M.B., B.S., Ph.D., from the Australian National University in Canberra, and colleagues randomly assigned adults with major trauma who were at risk for trauma-induced coagulopathy to receive tranexamic acid administered before hospital admission and after arrival at the hospital or matched placebo (661 and 646 patients, respectively).
The researchers found that survival with a favorable functional outcome at six months occurred in 53.7 and 53.5 percent of patients in the tranexamic acid and placebo groups, respectively (risk ratio, 1.00; 95 percent confidence interval, 0.90 to 1.12; P = 0.95). At 28 days after injury, 17.3 and 21.8 percent of patients in the tranexamic acid and placebo groups, respectively, had died (risk ratio, 0.79; 95 percent confidence interval, 0.63 to 0.99), and by six months, 19.0 and 22.9 percent had died (risk ratio, 0.83; 95 percent confidence interval, 0.67 to 1.03). There was no meaningful difference observed between the groups in the number of serious adverse events, including vascular occlusive events.
“The results appear to confirm the early survival benefit of tranexamic acid, but no benefit with respect to a favorable functional outcome at six months,” write the authors of an accompanying editorial.
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