Abstract
PurposeTo evaluate the pre-hospital administration of tranexamic acid in ambulance-treated trauma patients with a severe hemorrhage after the implementation of tranexamic acid administration in the Dutch pre-hospital protocol.MethodsAll patients with a severe hemorrhage who were treated and conveyed by EMS professionals between January 2015, and December 2017, to any trauma-receiving emergency department in the eight participating trauma regions in the Netherlands, were included. A severe hemorrhage was defined as extracranial injury with > 20% body volume blood loss, an extremity amputation above the wrist or ankle, or a grade >= 4 visceral organ injury. The main outcome was to determine the proportion of patients with a severe hemorrhage who received pre-hospital treatment with tranexamic acid. A Generalized Linear Model (GLM) was performed to investigate the relationship between pre-hospital tranexamic acid treatment and 24 h mortality.ResultsA total of 477 patients had a severe hemorrhage, of whom 124 patients (26.0%) received tranexamic acid before arriving at the hospital. More than half (58.4%) of the untreated patients were suspected of a severe hemorrhage by EMS professionals. Patients treated with tranexamic acid had a significantly lower risk on 24 h mortality than untreated patients (OR 0.43 [95% CI 0.19-0.97]).ConclusionApproximately a quarter of the patients with a severe hemorrhage received tranexamic acid before arriving at the hospital, while a severe hemorrhage was suspected in more than half of the non-treated patients. Severely hemorrhaging patients treated with tranexamic acid before arrival at the hospital had a lower risk to die within 24 h after injury.
Original language | English |
---|---|
Pages (from-to) | 139-147 |
Number of pages | 9 |
Journal | European Journal of Trauma and Emergency Surgery |
Volume | 50 |
Issue number | 1 |
Early online date | 1 Apr 2023 |
DOIs | |
Publication status | Published - Feb 2024 |
Keywords
- Tranexamic acid
- TXA
- Traumatic hemorrhage
- Pre-hospital
- EMS professionals
- Ambulance
- BLEEDING TRAUMA PATIENTS
- ACCURACY
- EPIDEMIOLOGY
- CRASH-2
- TRIAGE