Fayad Al-Haimus: Is Giving TXA Within ‘3 Hours’ Really Enough in Major Trauma?
Fayad Al-Haimus, Adult Thrombosis Fellow at McMaster University, shared a post on LinkedIn about a recent article by Adnan Ali et al. published in 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
Read the Full Article on Annals of Emergency Medicine
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