Summary of findings for the main comparison. Antifibrinolytic drugs for bleeding trauma patients.
| Antifibrinolytic drugs compared with placebo for treating bleeding trauma patients | ||||||
| Patient or population: Treating bleeding trauma patients Settings: Hospital settings in 40 countries (see http://www.crash2.lshtm.ac.uk/) Intervention: Antifibrinolytic drugs Comparison: Placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| placebo | Antifibrinolytic drugs | |||||
| Mortality | Study population | RR 0.90 (0.85 to 0.96) | 20437 (3 RCTs) | ⊕⊕⊕⊕ HIGH | ||
| 160 per 1000 | 144 per 1000 (136 to 153) | |||||
| Surgical intervention | Study population | RR 1.00 (0.97 to 1.03) | 20437 (3 RCTs) | ⊕⊕⊕⊕ HIGH | ||
| 476 per 1000 | 476 per 1000 (462 to 490) | |||||
| Blood transfusion | Study population | RR 0.98 (0.96 to 1.01) | 20367 (2 RCTs) | ⊕⊕⊕⊕ HIGH | ||
| 510 per 1000 | 500 per 1000 (489 to 515) | |||||
| Myocardial infarction | Study population | RR 0.61 (0.40 to 0.92) | 20367 (2 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | ||
| 6 per 1000 | 3 per 1000 (2 to 5) | |||||
| Deep vein thrombosis | Study population | RR 0.95 (0.62 to 1.47) | 20367 (2 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | ||
| 4 per 1000 | 4 per 1000 (3 to 6) | |||||
| Stroke | Study population | RR 0.86 (0.61 to 1.23) | 20367 (2 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | ||
| 6 per 1000 | 6 per 1000 (4 to 8) | |||||
| Pulmonary embolism | Study population | RR 1.01 (0.73 to 1.41) | 20367 (2 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | ||
| 7 per 1000 | 7 per 1000 (5 to 10) | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1Downgraded one level for imprecision: estimate based on few events and wide CIs.