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Antifibrinolytic drug may help prevent trauma patient deaths from blood loss
Roberts I. Cochrane Database Syst Rev. 2011;doi:10.1002/14651858.CD004896.pub3.
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Intervention with the antifibrinolytic agent tranexamic acid in bleeding trauma patients reduced mortality rates without raising the risk for adverse events, according to researchers.
Using data from four randomized controlled trials of patients who experienced heavy bleeding after severe injury (n=20,451), researchers assessed the effects of the antifibrinolytic agent tranexamic acid on mortality.
Mortality data was presented by cause in these categories: bleeding, vascular occlusion (myocardial infarction, stroke, pulmonary embolism), multi-organ failure, head injury and other. All-cause mortality was reduced with tranexamic acid by 10% (RR=0.90; 95% CI, 0.85-0.97). In one trial — the CRASH-2 2010 study (n=20,211) — data showed that tranexamic acid reduced the risk for death from bleeding by 15% (RR=0.85; 95% CI, 0.76-0.96). Researchers found no evidence that tranexamic acid increased the risk for vascular occlusive events or the need for surgical intervention. The difference between the number of necessary blood transfusions in the tranexamic acid and placebo group was negligible.
“Because [tranexamic acid] is inexpensive and easy to administer, it could readily be added to the normal medical and surgical management of bleeding trauma patients in hospitals around the world,” the researchers wrote.
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