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Tranexamic Acid Reduces Mortality in Trauma Patients

Drug safely reduces all-cause mortality and risk of death due to bleeding

TUESDAY, June 15 (HealthDay News) -- Tranexamic acid may be an effective option for reducing bleeding and mortality among trauma patients, without increasing the risk of serious complications such as myocardial infarction, stroke, or pulmonary embolism, according to a study published online June 15 in The Lancet.

In the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage 2 study, Haleema Shakur, of the London School of Hygiene and Tropical Medicine, and colleagues randomized 20,211 adult trauma patients with, or at risk for, significant bleeding to either tranexamic acid, loading dose 1 g over 10 min then infusion of 1 g over eight hours, or placebo within eight hours of injury.

The researchers found that all-cause mortality was significantly reduced with tranexamic acid, with 14.5 percent of patients receiving tranexamic acid dying compared with 16.0 percent receiving placebo (relative risk, 0.91). In addition, the risk of death due to bleeding was significantly reduced with tranexamic acid, with 4.9 percent of patients receiving tranexamic acid dying compared with 5.7 percent receiving placebo (relative risk, 0.85). The researchers observed no increase in complications, including myocardial infarction, stroke, and pulmonary embolism.

"In conclusion, tranexamic acid could be given in a wide range of health care settings, and safely reduced the risk of death in bleeding trauma patients in our study," the authors write. "The option to use tranexamic acid should be available to doctors treating trauma patients in all countries, and this drug should be considered for inclusion on the World Health Organization List of Essential Medicines."

The study was funded in part by Pfizer.

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