The Effect of Tranexamic Acid on Secondary Haemorrhage After Traumatic Hyphaema

Abstract

During the period from March 1978 to November 1979, 232 consecutive patients with traumatic hyphaema were allocated by admission-date to conservative treatment and to treatment with the antifibrinolytic drug tranexamic acid. Secondary haemorrhage occurred in only two of 102 tranexamic acid treated patients, while secondary haemorrhage occurred in 12 out of 130 conservatively treated patients. This difference was statistically significant. Some clinical aspects of the rebleeding cases are presented and briefly discussed.

Medical interventions for traumatic hyphema

“…A meta-analysis of these three studies showed no statistically significant effect of tranexamic acid (OR 1.65, 95% CI 0.91 to 2.99; Figure 4). In addition, Varnek 1980 reported mean VAs of 0.9 in both the tranexamic acid and control groups at day five after the trauma. VA was not reported by Welsh 1983.…”

“…Five studies investigated the use of oral tranexamic acid compared with a control in treating traumatic hyphema (Rahmani 1999; Sukumaran 1988; Vangsted 1983; Varnek 1980; Welsh 1983). There were 581 participants included in the studies; 279 were assigned to tranexamic acid and 302 to a control intervention.…”

“…In Vangsted 1983, 59 participants were randomized to receive tranexamic acid and 53 participants were randomized to receive complete bed rest for six days; follow-up was seven days. Varnek 1980 compared the same dose of tranexamic acid, 25 mg/kg daily for seven days along with hospitalization and bed rest (n = 102), versus hospitalization and bed rest alone in the control group (n = 130). Participants were followed for 12 days.…”

“…Masking of participants with the use of placebo pills could have been implemented, but was not achieved in the remaining two quasi-randomized studies (Sukumaran 1988; Varnek 1980). Masking of outcome assessors was not reported or not clear in all seven quasi-randomized studies.…”

“…We analyzed data from five studies reporting results comparing tranexamic acid versus control (Rahmani 1999; Sukumaran 1988; Vangsted 1983; Varnek 1980; Welsh 1983). Three studies were RCTs, and two were quasi-randomized controlled clinical trials.…”