TXA (Tranexamic Acid) Risk Evaluation in Combat Casualties (TRECC).

Area of Science:

• Trauma Surgery
• Hematology
• Military Medicine

Background:

• Tranexamic acid (TXA) is increasingly used for hemorrhage control in military trauma.
• Concerns exist regarding the potential for increased venous thromboembolism (VTE) following TXA administration.
• This study retrospectively evaluated VTE rates in severely injured military personnel.

Purpose of the Study:

• To determine the incidence of VTE in severely injured military trauma patients.
• To assess the association between TXA use and VTE development.
• To analyze specific VTE subtypes (DVT and PE) in relation to TXA.

Main Methods:

• Retrospective analysis of 859 military trauma patients (2009-2014) with Injury Severity Score (ISS) >10 and massive transfusion (MT).
• VTE events (DVT, PE) documented during hospitalization were recorded.
• Three multiple regression analyses (listwise deletion, systematic replacement, multiple imputation) were used to compare TXA vs. no TXA groups.

Main Results:

• 620 patients met inclusion criteria; 27% experienced a documented VTE.
• TXA use was associated with a 3% increased odds of VTE and a 9.4% increased odds of PE.
• Multiple imputation analysis indicated an 8.1% decreased odds of DVT with TXA administration.

Conclusions:

• TXA use in severely injured military patients undergoing massive transfusion is linked to a modest increase in VTE and PE odds.
• A decrease in DVT odds was observed.
• Further investigation into the long-term risks and benefits of TXA in this population is recommended.