Effectiveness and safety of prehospital tranexamic acid in patients with trauma: an updated systematic review and meta-analysis with trial sequential analysis

Effectiveness and safety of prehospital tranexamic acid in patients with trauma: an updated systematic review and meta-analysis with trial sequential analysis

The use of prehospital tranexamic acid (TXA) in patients with trauma has attracted considerable attention. This systematic review and meta-analysis aimed to provide the best evidence for clinicians.

Eleven studies (comprising 11,259 patients) were included; two of these were RCTs. The overall risks of bias were low in the RCTs. ROBINS-I risk of bias was Moderate in 3 studies, serious in 5 studies, and critical in 1 study. A significant reduction in 24-hour mortality was observed (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.71–0.94). A subgroup analysis that included only RCTs revealed that prehospital TXA was associated with reduced 28–30-day mortality (OR, 0.80; 95% CI, 0.66–0.97) and increased risks of thromboembolism (OR, 1.22; 95% CI, 1.03–1.44) and infection (OR, 1.13; 95% CI, 1.00–1.28) events. The blood products for transfusion decreased by 2.3 units on average (weighted mean difference [WMD], − 2.30; 95%CI, − 3.59 to − 1.01).

Hong-Yu Chen, Lun-Gang Wu, Chao-Chao Fan, Wei Yuan & Wan-Tang Xu

https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01119-2

BMC Emergency Medicine

25 oktober 2024

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