Prehospital Tranexamic Acid Combined with Blood Transfusion Reduced the Short-Term Mortality Risk in Trauma Patients...

Area of Science:

• Trauma resuscitation
• Hemorrhagic shock management
• Emergency medicine

Background:

• Hemorrhage is a primary cause of preventable trauma deaths.
• Prehospital blood transfusion and tranexamic acid (TXA) improve outcomes, but their combined effect is unclear.
• Uncertainty exists regarding the impact of early TXA administration alongside prehospital transfusions.

Purpose of the Study:

• To evaluate the effect of prehospital TXA combined with blood transfusion on short-term mortality in trauma patients.
• To assess the impact on 24-hour mortality, organ failure, and thromboembolic events.
• To determine if early TXA administration improves survival in severe hemorrhage.

Main Methods:

• Retrospective cohort study of 408 adult trauma patients at risk for hemorrhage (2018-2023).
• Comparison between transfusion-only group (n=240) and prehospital TXA plus transfusion group (n=168).
• Primary outcome: 30-day mortality; Secondary outcomes: 24-hour mortality, MOF, VTE, and resuscitation requirements.

Main Results:

• Prehospital TXA plus transfusion significantly reduced 30-day mortality (14.3% vs 31.3%, p<0.01) and 24-hour mortality (6.0% vs 19.6%, p<0.01).
• The TXA group showed lower multiple organ failure (MOF) incidence (14.3% vs 28.7%, p<0.01) and reduced plasma/crystalloid needs.
• No significant increase in venous thromboembolism (VTE) was observed (p=0.17); survival advantage confirmed by Kaplan-Meier and Cox regression (HR=2.16, p<0.01).

Conclusions:

• Prehospital TXA combined with blood transfusion enhances short-term survival in bleeding trauma patients.
• This combination therapy effectively reduces organ failure without elevating thromboembolic risks.
• Findings advocate for integrating TXA into prehospital transfusion protocols for improved trauma care.