A Retrospective Study of Transfusion Requirements in Trauma Patients Receiving Tranexamic Acid

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Pharmacology

Background:

• Previous studies like MATTERs and CRASH-2 suggest tranexamic acid (TXA) benefits trauma patients.
• Generalizability of prior TXA studies to civilian trauma populations in the U.S. remains a concern.
• Civilian air medical programs require data on TXA's effectiveness in their specific patient demographic.

Purpose of the Study:

• To evaluate the impact of tranexamic acid (TXA) on mortality, morbidity, and transfusion requirements in civilian trauma patients.
• To compare outcomes between trauma patients treated with TXA and a control group.
• To assess the feasibility and outcomes of TXA use in a civilian air medical setting.

Main Methods:

• Retrospective chart review of trauma patients transported by air to a Level 1 trauma center.
• Comparison of patient outcomes over two 2-year periods: pre-TXA implementation (2012-2014) and post-TXA implementation (2014-2016).
• Inclusion criteria focused on trauma patients meeting specific transport and treatment parameters.

Main Results:

• A total of 52 control (non-TXA) and 43 TXA-treated patients were analyzed.
• TXA recipients exhibited increased patient acuity and higher transfusion requirements compared to the control group.
• Despite increased acuity, patients receiving TXA demonstrated reduced mortality.

Conclusions:

• Tranexamic acid (TXA) administration in this civilian trauma cohort is associated with decreased mortality, even with higher patient acuity.
• Increased acuity in TXA recipients correlated with greater transfusion needs.
• Further investigation into patient selection for TXA, considering fibrinolysis and provider bias, is warranted, alongside randomized controlled trials.