Benefits of the tranexamic acid in head trauma with no extracranial bleeding: a prospective follow-up of 180 patients

Chakroun-Walha, Olfa; Samet, Amal; Jerbi, M.; Nasri, Abdennour; Talbi, Aziza; Kanoun, Hassen; Souissi, B.; Chtara, Kamilia; Bouaziz, Mounir; Ksibi, Hichem; Rekik, Noureddine

doi:10.1007/s00068-018-0974-z

Cited by 47 publications

(61 citation statements)

References 31 publications

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“…All studies were published in English. All included studies reported mortality [4,5,[10][11][12][13], three studies reported growth of hemorrhagic mass [10,12,13], four reported disability or dependent [4,5,12,13], three studies reported neurosurgery [11][12][13], three reported vascular embolism [4,5,11], and three reported stroke [4,5,13]. Details of the risk of bias graph ( Fig.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

The effect of tranexamic acid in patients with TBI: a systematic review and meta-analysis of randomized controlled trials

Liu

et al. 2020

Chin Neurosurg Jl

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To conduct a systematic review and meta-analysis and evaluate the effect of tranexamic acid in patients with traumatic brain injury. PubMed, EMBASE, and CENTRAL (Cochrane Central Register of Controlled Trials) were searched to identify randomized controlled trials and evaluate the effect of tranexamic acid in traumatic brain injury patients. The primary outcome was mortality. Two reviewers extracted the data independently. The random effect meta-analysis was used to estimate the aggregate effect size of 95% confidence intervals. Six randomized controlled trials investigating tranexamic acid versus placebo and 30073 patients were included. Compared with placebo, tranexamic acid decreased the mortality (RR = 0.92; 95% CI, 0.87-0.96; p < 0.001) and growth of hemorrhagic mass (RR = 0.78; 95% CI, 0.61-0.99; p = 0.04). However, tranexamic acid could not decrease disability or independent, neurosurgery, vascular embolism, and stroke. Current evidence suggested that compared with placebo, tranexamic acid could reduce mortality and growth of hemorrhagic mass. This finding indicated that patients with traumatic brain injury should be treated with tranexamic acid.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

The effect of tranexamic acid in patients with TBI: a systematic review and meta-analysis of randomized controlled trials

Liu

et al. 2020

Chin Neurosurg Jl

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“…(Fig. 1) There were a total of 30.522patients from 7 studies [9][10][11][12][13][14][15]. The TXA protocol was mostly 1 g TXA infused over 10 min, followed by IV infusion of 1 g over 8 h. There was 1 study that gave bolus initially and another study that gave initial dose over 30 min.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…TXA was also associated with enhanced clot strength, reduction in trauma-induced coagulopathy, and prevention of hyperfibrinolysis [8]. However, clinical trials demonstrate conflicting results regarding the benefits of the TXA in TBI patients [9][10][11][12]. The risk of thromboembolic complications is also uncertain as one study reported a significantly higher risk of pulmonary embolism (PE) in patients treated with TXA [9].…”

Section: Introductionmentioning

confidence: 99%

Tranexamic acid is associated with reduced mortality, hemorrhagic expansion, and vascular occlusive events in traumatic brain injury – meta-analysis of randomized controlled trials

July

Pranata

2020

BMC Neurol

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Background: This systematic review and meta-analysis aimed to synthesize the latest evidence on the efficacy and safety of tranexamic acid (TXA) on traumatic brain injury (TBI). Methods:We performed a systematic literature search on topics that compared intravenous TXA to placebo in patients with TBI up until January 2020 from several electronic databases.Results: There were 30.522 patients from 7 studies. Meta-analysis showed that TXA was associated with reduced mortality (RR 0.92 [0.88, 0.97], p = 0.002; I 2 : 0%) and hemorrhagic expansion (RR 0.79 [0.64, 0.97], p = 0.03; I 2 : 0%). Both TXA and control group has a similar need for neurosurgical intervention (p = 0.87) and unfavourable Glasgow Outcome Scale (GOS) (p = 0.59). The rate for vascular occlusive events (p = 0.09), and its deep vein thrombosis subgroup (p = 0.23), pulmonary embolism subgroup (p = 1), stroke subgroup (p = 0.38), and myocardial infarction subgroup (p = 0.15) were similar in both groups. Subgroup analysis on RCTs with low risk of bias showed that TXA was associated with reduced mortality and hemorrhagic expansion. TXA was associated with reduced vascular occlusive events (RR 0.85 [0.73, 0.99], p = 0.04; I 2 : 4%). GRADE was performed for the RCT with low risk of bias subgroup, it showed a high certainty of evidence for lower mortality, less hemorrhage expansion, and similar need for neurosurgical intervention in TXA group compared to placebo group.Conclusion: TXA was associated with reduced mortality and hemorrhagic expansion but similar need for neurosurgical intervention and unfavorable GOS. Vascular occlusive events were slightly lower in TXA group on subgroup analysis of RCTs with low risk of bias.

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“…( Figure 1) There were a total of 30.522 patients from 7 studies. [9][10][11][12][13][14][15] The TXA protocol was mostly 1 g TXA infused over 10 minutes, followed by IV infusion of 1 g over 8 h.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Tranexamic Acid is Associated with Reduced Mortality, Hemorrhagic Expansion, and Vascular Occlusive Events in Traumatic Brain Injury – Meta-analysis of Randomized Controlled Trials

July

Pranata

2020

Preprint

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Introduction This systematic review and meta-analysis aimed to synthesize the latest evidence on the efficacy and safety of tranexamic acid (TXA) on traumatic brain injury (TBI). Methods We performed a systematic literature search on topics that compared intravenous TXA to placebo in patients with TBI up until January 2019 from several electronic databases. Results There were 30.522‬ patients from 7 studies. Meta-analysis showed that TXA was associated with reduced mortality (RR 0.92 [0.88, 0.97], p=0.002; I 2 : 0%) and hemorrhagic expansion (RR 0.79 [0.64, 0.97], p=0.03; I 2 : 0%). Both TXA and control group has a similar need for neurosurgical intervention (p=0.87) and unfavourable Glasgow Outcome Scale (GOS) (p=0.59). The rate for vascular occlusive events (p=0.09), and its deep vein thrombosis subgroup (p=0.23), pulmonary embolism subgroup (p=1), stroke subgroup (p=0.38), and myocardial infarction subgroup (p=0.15) were similar in both groups. Subgroup analysis on RCTs with low risk of bias showed that TXA was associated with reduced mortality and hemorrhagic expansion. TXA was associated with reduced vascular occlusive events (RR 0.85 [0.73, 0.99], p=0.04; I 2 : 4%). GRADE was performed for the RCT with low risk of bias subgroup, it showed a high certainty of evidence for lower mortality, less hemorrhage expansion, and similar need for neurosurgical intervention in TXA group compared to placebo group. Conclusion TXA was associated with reduced mortality and hemorrhagic expansion but similar need for neurosurgical intervention and unfavorable GOS. Vascular occlusive events were slightly lower in TXA group on subgroup analysis of RCTs with low risk of bias.

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Benefits of the tranexamic acid in head trauma with no extracranial bleeding: a prospective follow-up of 180 patients

Cited by 47 publications

References 31 publications

The effect of tranexamic acid in patients with TBI: a systematic review and meta-analysis of randomized controlled trials

The effect of tranexamic acid in patients with TBI: a systematic review and meta-analysis of randomized controlled trials

Tranexamic acid is associated with reduced mortality, hemorrhagic expansion, and vascular occlusive events in traumatic brain injury – meta-analysis of randomized controlled trials

Tranexamic Acid is Associated with Reduced Mortality, Hemorrhagic Expansion, and Vascular Occlusive Events in Traumatic Brain Injury – Meta-analysis of Randomized Controlled Trials

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