Safety of Tranexamic Acid During Pediatric Trauma: A Nationwide Database Study

The present study aimed to examine the association between tranexamic acid use and adverse effects (seizures, thromboembolism, and renal dysfunction) in a pediatric trauma population using a national inpatient database in Japan. We also assessed the association between tranexamic acid use and in-hospital mortality.

A nationwide, retrospective cohort study using propensity score analyses.

Japanese Diagnosis Procedure Combination inpatient database.

Pediatric patients less than or equal to 12 years old admitted in hospital with the diagnosis of trauma between July 2010 and March 2014 (n = 61,779).

None.

Propensity score matching created 1,914 pairs of patients with and without tranexamic acid administration. Propensity-matched analysis showed that the proportion of seizures was significantly higher in the tranexamic acid group than in the nontranexamic acid group (7/1,914, 0.37% vs 0/1,914, 0%; difference, 0.37%; 95% CI, 0.10-0.64; p = 0.008). However, none of the other outcomes were significantly different between the groups.

Tranexamic acid use is associated with a significantly increased risk of seizures. However, no difference exists among any other outcomes between the tranexamic acid and nontranexamic acid groups.