The effect of prehospital tranexamic acid on outcome in polytrauma patients with associated severe brain injury
| Autor: | Denise Jochems, Luke P. H. Leenen, Karlijn J P van Wessem |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Resuscitation Traumatic brain injury Shock Hemorrhagic Critical Care and Intensive Care Medicine Trauma Centers TBI Brain Injuries Traumatic medicine Humans Orthopedics and Sports Medicine Prospective Studies Mortality Prospective cohort study Abbreviated Injury Scale business.industry Multiple Trauma Trauma center Polytrauma Middle Aged medicine.disease Antifibrinolytic Agents Blood pressure Tranexamic Acid Anesthesia Brain Injuries Emergency Medicine Original Article Surgery Female Morbidity business Tranexamic acid medicine.drug |
| Zdroj: | European Journal of Trauma and Emergency Surgery |
| ISSN: | 1863-9941 |
| Popis: | Introduction Tranexamic acid (TXA) has shown to be beneficial in selected patients with hemorrhagic shock. Recently, TXA has gained interest in isolated traumatic brain injury (TBI) patients with variable results. There are limited data on TXA in polytrauma with associated TBI. This study investigated the role of TXA in severely injured patients with associated severe TBI. Methods A 7.5-year prospective cohort study was performed to investigate the relation between prehospital TXA and mortality in consecutive trauma patients with associated severe TBI (Abbreviated Injury Scale (AIS)head ≥ 3) admitted to a Level-1 Trauma Center ICU. Indication for prehospital TXA administration was (suspicion of) hemorrhagic shock, and/or systolic blood pressure (SBP) ≤ 90 mmHg. Demographics, data on physiology, resuscitation, and outcomes were prospectively collected. Results Two hundred thirty-four patients (67% males) with median age of 49 years and ISS 33 (98% blunt injuries) were included. Thirteen patients (6%) developed thromboembolic complications; mortality rate was 24%. Fifty-one percent of patients received prehospital TXA. TXA patients were younger, had more deranged physiology on arrival, and received more crystalloids and blood products ≤ 24 h. There was, however, no difference in overall outcome between TXA patients and no-TXA patients. Conclusions Despite having a more deranged physiology TXA patients had similar outcome compared to no-TXA patients who were much older. Thromboembolic complication rate was low. Prehospital tranexamic acid has no evident effect on outcome in polytrauma patients with associated critical brain injury. Supplementary Information The online version contains supplementary material available at 10.1007/s00068-021-01827-5. |
| Databáze: | OpenAIRE |
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