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Empiric Use of Tranexamic Acid in Geriatric Trauma is Not Associated With Blood Product Utilization, Survival, or
Kristen M Kelliher1, Carolyne R Falank1, Peter Kyros1
1Department of Surgery, MaineHealth Maine Medical Center, Portland, Maine.
Introduction:
The benefits of the empiric use of tranexamic acid (TXA) in geriatric trauma patients remain to be elucidated. Our study objectives were to examine any association with TXA treatment with thromboembolic complications, blood product utilization, mortality, and hospital outcomes.
Methods:
Retrospective registry review of a single rural level 1 trauma center of patients ≥65 years of age who received empiric TXA between January 1, 2014 and July 30, 2024 were studied. A matched cohort for injury severity score, abbreviated injury scale (AIS) for all body regions, gender, age, and those who received >1 unit of blood product control group were used in a 2:1 paired case-control study.
Results:
Twenty-one geriatric patients received empiric TXA. There was no difference in age, yrs (78 ± 7.1; 78.6 ± 8.4, P = 0.38), gender (P = 1), mechanism of injury, median injury severity score (17 [IQR 11.5, 22]; 17 [ IQR 9, 29], P = 0.28), median AIS head (3 [IQR 3, 4]; 3 [IQR 1, 5], P = 0.27), median AIS thorax (3 [IQR 2, 3]; 3 [IQR 2, 3], P = 0.37), median AIS abdomen (2 [IQR 1, 4]; 3 [IQR 2, 4]; P = 0.17); median AIS spine (2 [IQR 2, 2.75]; 2 [IQR 2, 3], P = 0.50); median AIS upper extremity (1 [IQR 1, 2]; 1 [IQR 1, 2], P = 0.27), median AIS lower extremity (2 [ IQR 1, 3]; 3 [IQR 1, 3], P = 0.38), Glasgow coma score (11.7 ± 4.8; 12 ± 4.8, P = 0.41), thromboembolic complications (P = 0.13), blood product utilization (P = 0.07), mortality (P = 1), ICU length of stay (P = 0.23), and hospital length of stay (P = 0.16).
Conclusions:
TXA was not associated with changes in mortality, VTE, or blood product use in geriatric trauma.
