Tranexamic acid reduces mortality in trauma patients

Tranexamic acid may be an effective option for reducing bleeding and mortality among trauma patients, without increasing the risk of serious complications such as myocardial infarction, stroke, or pulmonary embolism, according to a study published online June 15 in The Lancet, reported HealthDay News.

In the CRASH-2 (Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage 2) study, Haleema Shakur, of the London School of Hygiene and Tropical Medicine, and colleagues randomly assigned 20,211 adult trauma patients with, or at risk for, significant bleeding to either tranexamic acid, loading dose 1 g over 10 min then infusion of 1 g over 8 h, or placebo within 8 h of injury.

The researchers found that all-cause mortality was significantly reduced with tranexamic acid, with 14.5% of patients receiving tranexamic acid dying compared with 16.0% receiving placebo (RR, 0.91). In addition, the risk of death due to bleeding was significantly reduced with tranexamic acid, with 4.9% of patients receiving tranexamic acid dying compared with 5.7% receiving placebo (relative risk, 0.85). The researchers observed no increase in complications, including myocardial infarction, stroke, and pulmonary embolism.

"In conclusion, tranexamic acid could be given in a wide range of healthcare settings, and safely reduced the risk of death in bleeding trauma patients in our study," the authors wrote. "The option to use tranexamic acid should be available to doctors treating trauma patients in all countries, and this drug should be considered for inclusion on the World Health Organization List of Essential Medicines."

The study was funded in part by Pfizer.