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Fayad Al-Haimus: Is Giving TXA Within “3 Hours” Really Enough?

Fayad Al-Haimus/LinkedIn

Feb 2, 2026, 10:31

Fayad Al-Haimus: Is Giving TXA Within “3 Hours” Really Enough?

Fayad Al-Haimus, Adult Thrombosis Fellow at McMaster University, shared on LinkedIn about a recent article by Adnan Ali et al, published in The Annals of Emergency Medicine:

”Important study to highlight:

Is giving TXA within “3 hours” really enough?

A new Annals of Emergency Medicine analysis from the PATCH-Trauma trial challenges how we think about tranexamic acid (TXA) in major trauma.

Study context:
PATCH-Trauma enrolled >1,300 patients with major trauma across 15 EMS services and 21 trauma centres in Australia, New Zealand, and Germany.

The new study was exploratory, post-hoc analysis of the trial.

Key finding:
TXA was associated with a significant reduction in 28-day mortality when given within ~90 minutes of injury.

<90 min: 17% vs 25% mortality (TXA vs placebo). Adjusted RR 0.64 (95% CI 0.50–0.82)
≥90 min: no mortality benefit (adjusted RR 1.04)

This is notable because:
• PATCH used precise prehospital timestamps, unlike CRASH-2
• TXA was given early, prehospital

Takeaway:
As trauma care becomes more precision-focused, this study adds to the growing signal that early hemostatic decisions matter as much as what we give.”

Title: Tranexamic Acid Timing and Mortality Impact After Trauma

Authors: Adnan Ali, Russell L. Gruen, Stephen A. Bernard, Brian Burns, Andrew B. Forbes, Dashiell C. Gantner, Colin J. McArthur, Marc Maegele, Biswadev Mitra on behalf of PATCH-Trauma trial investigators

Read the Full Article on The Annals of Emergency

Fayad Al-Haimus: Is Giving TXA Within “3 Hours” Really Enough?