A Retrospective Study of Transfusion Requirements in Trauma Patients Receiving Tranexamic Acid.
Brian Cornelius, Kelsey Moody, Katelyn Hopper and 4 others
PMID 31483769WHAT IT FOUND
Trauma patients given tranexamic acid received more blood products, not fewer.
They had more severe injuries, and mortality was lower in a non-randomized comparison.
Key findings
01Patients who received TXA had increased volumes of all blood products reviewed, including fresh frozen plasma, red blood cells, platelets, and cryoprecipitate.
02The TXA group was slightly worse on several injury and physiologic measures, including lower initial systolic blood pressure, lower arrival systolic blood pressure, lower arrival Glasgow Coma Score, lower TRISS, and higher INR.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a retrospective comparison, not a randomized trial, and the TXA group was sicker, so differences may reflect injury severity rather than TXA. Only 95 patients met inclusion criteria, and 2 control patients were minors and excluded. Not all TXA patients received the follow-up infusion, so the full protocol was not tested. The study mixed patients transported from the scene and patients transferred from other facilities, and it did not identify sex. The supplied text gives no exact transfusion volumes, mortality counts, or statistical significance for the primary transfusion outcome. Thromboelastogram was not routinely used and was not included in analysis.
The easy way to misread this
Do not conclude that tranexamic acid reduced transfusion requirements. The TXA group received more blood products and was sicker, and the comparison was not randomized.