Table 2.
Authors | Year | Entry criteria of trauma patients | No. of patients | Mean ISS | Rate of VTE | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Total | TXA | No TXA | TXA | No TXA | p value | TXA (%) | No TXA (%) | p value | |||
RCTs | |||||||||||
Shakur et al. [14] | 2010 | Adult trauma patients with, or at risk of, significant bleeding | 20,127 | 10,060 | 10,067 | N.A. | N.A. | N.A. | 1.7a | 2.0a | 0.084 |
Yutthakasemsun et al. [42] | 2013 | Adult trauma patients with moderate to severe traumatic brain injury (post-resuscitation Glasgow Coma Scale 4 to 12) | 238 | 120 | 118 | N.A. | N.A. | N.A. | 0 | 0 | – |
Observational studies | |||||||||||
Morrison et al. [38] | 2012 | Patients who received at least 1 unit of PRBCs within 24 h of admission following combat-related injury | 896 | 293 | 603 | 25.2 | 22.5 | <0.001 | 2.7 | 0.3 | 0.001 |
Swendsen et al. [41] | 2013 | Adult trauma patients who met triage criteria for serious injury and at least one of the following: hypotension, massive transfusion guideline activation, or transport directly to the operating room or interventional radiology suite | 126 | 52 | 74 | 27.1 | 20.5 | 0.02 | 11.5 | 0 | 0.004 |
Haren et al. [43] | 2014 | Adult trauma patients with hypercoagulable state defined as Greenfield’s risk assessment profile (RAP) ≥10 | 121 | 27 | 94 | 31 | 26 | 0.117 | 33 | 27 | 0.492 |
Harvin et al. [44] | 2014 | Adult trauma patients with hyperfibrinolysis determined by rapid thrombelastography | 1032 | 98 | 934 | 29 | 14 | <0.001 | 6.3 | 4.4 | 0.389 |
Cole et al. [19] | 2015 | Adult trauma patients with severe injury defined as injury severity score (ISS) >15 | 385 | 160 | 225 | 33 | 29 | <0.05 | 5 | 4 | ns |
Wafaisade et al. [45] | 2016 | Trauma patients with/without prehospital TXA administration | 516 | 258 | 258 | 24 | 24 | 0.46 | 5.6 | 8.3 | 0.58 |
ISS injury severity score, VTE venous thromboembolism, RCTs randomized controlled trials, TXA tranexaminc acid, N.A. not available, ns not significant
aThese data indicate the rate of pulmonary embolisms