Evidence map›Paper›PMID 33079217›Full record

SynthesisIntensive care medicine2021

Efficacy and safety of tranexamic acid in acute traumatic brain injury: a systematic review and meta-analysis of randomized-controlled trials.

Kumait Al Lawati, Sameer Sharif, Said Al Maqbali, Hussein Al Rimawi, Andrew Petrosoniak, Emilie P Belley-Cote, Sunjay V Sharma, Justin Morgenstern, Shannon M Fernando, Julian J Owen and 4 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 7 pooled it
4.6field-weighted citation impact, top 4% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 7 syntheses or guidelines pooled it, 83 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Pooled it
  8. Trial
  9. Tranexamic Acid in Pediatric Care: A Comprehensive Overview.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2026
    Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Letter to the editor.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024
    Article
  17. Chemical Adjustment of Fibrinolysis.Pharmaceuticals (Basel, Switzerland) · 2024
    Article
  18. Review
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 2 countries.

Kumait Al LawatiDivision of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Sameer SharifDivision of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada. sameer.sharif@medportal.ca.ORCID http://orcid.org/0000-0002-3346-0308
Said Al MaqbaliDivision of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Hussein Al RimawiDivision of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Andrew PetrosoniakDivision of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Emilie P Belley-CoteDivision of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Sunjay V SharmaDivision of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Justin MorgensternDivision of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
Shannon M FernandoDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Julian J OwenDivision of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Michelle ZellerMcMaster Centre for Transfusion Research, McMaster University and Canadian Blood Services, Hamilton, Canada.
David QuinlanDivision of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Waleed AlhazzaniDivision of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Bram RochwergDivision of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.
McMaster University · CAImpact · CAOman Medical College · OMUniversity of Toronto · CACanadian Blood Services · CAPopulation Health Research Institute · CAUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWith the publication of a large randomized-controlled trial (RCT) suggesting that tranexamic acid (TXA) may improve head-injury-related deaths, we aimed to determine the safety and efficacy of TXA in acute traumatic brain injury (TBI).

methodsIn this systematic review and meta-analysis, we searched MEDLINE, PubMed, EMBASE, CINHAL, ACPJC, Google Scholar, and unpublished sources from inception until June 24, 2020 for randomized-controlled trials comparing TXA and placebo in adults and adolescents (≥ 15 years of age) with acute TBI. We screened studies and extracted summary estimates independently and in duplicate. We assessed the quality of evidence using the grading of recommendations assessment, development, and evaluation approach. This study is registered with PROSPERO (CRD42020164232).

resultsNine RCTs enrolled 14,747 patients. Compared to placebo, TXA had no effect on mortality (RR 0.95; 95% CI 0.88-1.02; RD 1.0% reduction; 95% CI 2.5% reduction to 0.4% increase, moderate certainty) or disability assessed by the Disability Rating Scale (MD, - 0.18 points; 95% CI - 0.43 to 0.08; moderate certainty). TXA may reduce hematoma expansion on subsequent imaging (RR 0.77; 95% CI 0.58-1.03, RD 3.6%, 95% CI 6.6% reduction to 0.5% increase, low certainty). Risks of adverse events (all moderate, low, or very low certainty) were similar between placebo and TXA.

conclusionsIn patients with acute TBI, TXA probably has no effect on mortality or disability. TXA may decrease hematoma expansion on subsequent imaging; however, this outcome is likely of less importance to patients. The use of TXA probably does not increase the risk of adverse events.

Indexed as

Brain InjuriesBrain Injuries, TraumaticTranexamic AcidAdolescentAdultHumansRandomized Controlled Trials as TopicTranexamic AcidBrain injuryClinical trialRandomizedTranexamic acidTraumatic

Identifiers

PMID33079217
OpenAlexW3092703164

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.