1
|
Javeed SS, Altawili MA, Almubarak LNA, Alaodah SA, Alqarni MMA, Odeh OI, Asiri MAB, Alotaibi RAM, Alshammari AAA, Alqutayfi ZAM, Altemani OSD, Al Gharban DAM, Zafar ZA. The Effectiveness of Prehospital Administration of Tranexamic Acid in Reducing Mortality in Trauma Patients: An Overview. Cureus 2023; 15:e49784. [PMID: 38161561 PMCID: PMC10757764 DOI: 10.7759/cureus.49784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Tranexamic acid (TXA) is an antifibrinolytic drug that reduces bleeding by inhibiting plasminogen activation and fibrin clot degradation. Its role in prehospital trauma management remains unclear. This article aims to systematically review the current evidence on the effect of prehospital TXA administration on mortality in adult and pediatric trauma patients. A literature search was conducted of PubMed, Web of Science, Scopus, and Cochrane databases from March 2023 to August 2023 for studies evaluating the impact of prehospital TXA use on trauma mortality. Inclusion criteria were articles published in the English language in the past 20 years focusing on clinical outcomes of prehospital TXA administration. Data on all-cause mortality, thromboembolic events, and time to TXA administration were extracted. In adult trauma, prehospital TXA appears to reduce early all-cause mortality when given within three hours of injury without increasing thromboembolic risks. Some studies found decreased delayed mortality, while others found no difference. In pediatric trauma, preliminary evidence suggests TXA may lower in-hospital mortality in hemodynamically unstable patients, though higher doses may increase seizure risk. Early prehospital administration of TXA within three hours of adult trauma may reduce mortality through improved hemorrhage control. Potential benefits in pediatric trauma warrant further investigation, balancing efficacy against safety risks such as seizures from high doses. Well-designed randomized trials are needed to validate optimal TXA dosing strategies across age groups and injury severity levels.
Collapse
Affiliation(s)
- Syed S Javeed
- Emergency Medicine, King Salman Armed Forces Hospital, Tabuk, SAU
| | | | | | | | | | - Omar I Odeh
- Medical School, King Saud University College of Medicine, Riyadh, SAU
| | | | | | | | | | | | | | - Zohair A Zafar
- General Practice, Al-Awali Primary Health Care Center, Makkah, SAU
| |
Collapse
|