- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Prehospital tranexamic acid may not lower hemorrhage risk in trauma patients: JAMA
![Prehospital tranexamic acid may not lower hemorrhage risk in trauma patients: JAMA Prehospital tranexamic acid may not lower hemorrhage risk in trauma patients: JAMA](https://medicaldialogues.in/h-upload/2020/01/21/750x450_123355-hospitalization.jpg)
USA: The administration of tranexamic acid before hospitalization in injured patients at hemorrhage risk although is safe but it did not significantly lower mortality risk, according to a recent study in the journal JAMA Surgery. Further, the administration of prehospital tranexamic acid within 1 hour of injury and in those having prehospital severe shock resulted in lower 30-day mortality. This necessarily means providing prehospital tranexamic acid during ground or air transport is safe and can be provided to patients at hemorrhage risk.
The administration of prehospital tranexamic acid during air or ground transport is safe and can be provided to patients at risk for hemorrhage.
Trauma is a leading cause of death worldwide. In-hospital administration of tranexamic acid after injury improves outcomes in patients at hemorrhage risk. However, there is a lack of data demonstrating the safety and benefit of tranexamic acid use before hospitalization in these patients.
Francis X. Guyette, University of Pittsburgh, Pittsburgh, Pennsylvania, and colleagues assessed the safety and effectiveness of tranexamic acid administered before hospitalization compared with placebo in injured patients at risk for hemorrhage.
The trial included injured patients with prehospital hypotension (systolic blood pressure ≤90 mm Hg) or tachycard ia (heart rate ≥110/min) before arrival at 1 of 4 US level 1 trauma centers. They had an estimated 2 hours of injury, from May 1, 2015, through October 31, 2019.
The patients were randomized to receive either 1 g of tranexamic acid (447 patients) or placebo (456 patients) before hospitalization. Both the interventions were infused for 10 minutes in 100 mL of saline.
The primary outcome was 30-day all-cause mortality.
Key findings of the study include:
- Mortality at 30 days was 8.1% in patients receiving tranexamic acid compared with 9.9% in patients receiving placebo (difference, –1.8%).
- Results of Cox proportional hazards regression analysis, accounting for site, verified that randomization to tranexamic acid was not associated with a significant reduction in 30-day mortality (hazard ratio, 0.81).
- Prespecified dosing regimens and post-hoc subgroup analyses found that prehospital tranexamic acid were associated with significantly lower 30-day mortality.
- When comparing tranexamic acid effect stratified by time to treatment and qualifying shock severity in a post hoc comparison, 30-day mortality was lower when tranexamic acid was administered within 1 hour of injury (4.6% vs 7.6%).
- Patients with severe shock (systolic blood pressure ≤70 mm Hg) who received tranexamic acid demonstrated lower 30-day mortality compared with placebo (18.5% vs 35.5%).
"Tranexamic acid given to injured patients at risk for hemorrhage in the prehospital setting is safe and associated with a survival benefit in specific subgroups of patients," concluded the authors.
The study, "Tranexamic Acid During Prehospital Transport in Patients at Risk for Hemorrhage After Injury: A Double-blind, Placebo-Controlled, Randomized Clinical Trial," is published in the journal JAMA Surgery.
DOI: https://jamanetwork.com/journals/jamasurgery/fullarticle/2771225
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751