Evidence map›Paper›PMID 25447601›Full record

SynthesisThe American journal of emergency medicine2014

Tranexamic acid for traumatic brain injury: a systematic review and meta-analysis.

Shahriar Zehtabchi, Samah G Abdel Baki, Louise Falzon, Daniel K Nishijima

Registry-linked trialOpen access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The American journal of emergency medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04742205 (Effectiveness of Intravenous Tranexamic Acid in Primary Cerebral Hemorrhage for Prevention of Hematoma Progression), which is not on this map. Cited by 28 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 5 pooled it
4.1field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04742205 phase2 / phase3completednot on this mapstarted 2021, after this paper: background citation

Effectiveness of Intravenous Tranexamic Acid in Primary Cerebral Hemorrhage for Prevention of Hematoma Progression: Protocol for a Randomized, Double Blind Placebo-controlled Trial

TypeinterventionalSponsorKathmandu Medical College and Teaching HospitalRan2021 to 2024Enrolled154ConditionsCerebral HemorrhageArmsTranexamic Acid 500 MG
3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 5 syntheses or guidelines pooled it, 95 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Systemic hemostatic agents initiated in trauma patients in the pre-hospital setting: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Pooled it
  5. Pooled it
  6. Benefits of the tranexamic acid in head trauma with no extracranial bleeding: a prospective follow-up of 180 patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2019
    Trial
  7. Trial
  8. The effect of tranexamic acid in traumatic brain injury: A randomized controlled trial.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2017
    Trial
  9. Trial
  10. Trial
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Shahriar ZehtabchiDepartment of Emergency Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY. Electronic address: Shahriar.zehtabchi@downstate.edu.
Samah G Abdel BakiDepartment of Emergency Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY. Electronic address: samahabdulbaki@gmail.com.
Louise FalzonCenter for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, NY. Electronic address: af2215@cumc.columbia.edu.
Daniel K NishijimaDepartment of Emergency Medicine, University of California, Davis, CA. Electronic address: daniel.nishijima@ucdmc.ucdavis.edu.
State University of New York · USColumbia University Irving Medical Center · USUniversity of California, Davis · US

Funding

UC Davis Clinical and Translational Science CenterUL1TR000002 · NCATS · UNIVERSITY OF CALIFORNIA AT DAVIS · PI BERGLUND, LARS F · 2012 to 2015
$12.2M
Wireless Novel MicroEEG for Neonatal Apnea and Community Neurological NetworkR41HD072881 · NICHD · BIO-SIGNAL GROUP CORPORATION · PI ABDEL BAKI, SAMAH, CHARI, GEETHA · 2012 to 2013
$620k
NCATS NIH HHS UL1 TR000002NICHD NIH HHS 5R41HD072881-02NICHD NIH HHS R41 HD072881
6 · The paper itself

Abstract

objectiveThe antifibrinolytic agent tranexamic acid (TXA) has demonstrated clinical benefit in trauma patients with severe bleeding, but its effectiveness in patients with traumatic brain injury (TBI) is unclear. We conducted a systematic review to evaluate the following research question: In ED patients with or at risk of intracranial hemorrhage (ICH) secondary to TBI, does TXA compared to placebo improve patients' outcomes?

methodsMEDLINE, EMBASE, CINAHL, and other databases were searched for randomized controlled trial (RCT) or quasi-RCT studies that compared the effect of TXA to placebo on outcomes of TBI patients. The main outcomes of interest included mortality, neurologic function, hematoma expansion, and adverse effects. We used "Grading quality of evidence and strength of recommendations" to assess the quality of trials. Two authors independently abstracted data using a data collection form. Results from studies were pooled when appropriate.

resultsOf 1030 references identified through the search, 2 high-quality RCTs met inclusion criteria. The effect of TXA on mortality had a pooled relative risk of 0.64 (95% confidence interval [CI], 0.41-1.02); on unfavorable functional status, a relative risk of 0.77 (95% CI, 0.59-1.02); and on ICH progression, a relative risk of 0.76 (95% CI, 0.58-0.98). No serious adverse effects (such as thromboembolic events) associated with TXA group were reported in the included trials.

conclusionPooled results from the 2 RCTs demonstrated statistically significant reduction in ICH progression with TXA and a nonstatistically significant improvement of clinical outcomes in ED patients with TBI. Further evidence is required to support its routine use in patients with TBI.

Indexed as

Antifibrinolytic AgentsBrain InjuriesHumansIntracranial HemorrhagesRandomized Controlled Trials as TopicTranexamic AcidAntifibrinolytic AgentsTranexamic Acid

Identifiers

PMID25447601
PMCPMC4988127
OpenAlexW2095755948

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.