Trial reportThe journal of trauma and acute care surgery2020
Tranexamic acid administration in the field does not affect admission thromboelastography after traumatic brain injury.
Trial report in The journal of trauma and acute care surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition.Critical care (London, England) · 2023Guideline
- Optimizing hemorrhage management in trauma: integrative roles of tranexamic acid and tissue plasminogen activator-augmented viscoelastic testing.Journal of thrombosis and thrombolysis · 2026Review
- Precision hemostasis: how viscoelastic testing guides real-time decision-making in trauma.Trauma surgery & acute care open · 2026Review
- Viscoelastic Hemostatic Assays in the Management of Trauma-Induced Coagulopathy: A Clinical Update.Journal of clinical medicine · 2025Review
- Tranexamic Acid and Systemic Complement Activation in Traumatic Brain Injury Patients.Journal of the American College of Surgeons · 2025Article
- Implementation status of European guidelines on trauma management of prehospital bleeding control: a national survey in Austria.BMC emergency medicine · 2025Article
- Hemostatic disturbances in traumatic brain injury: from mechanism to management.Acta neurochirurgica · 2025Review
- Construction and validation of a nomogram for blood transfusion after open reduction and internal fixation (ORIF) of proximal humeral fractures in the elderly: a cross-sectional study.BMC musculoskeletal disorders · 2024Article
- Revolutionizing trauma care: advancing coagulation management and damage control anesthesia.Anesthesia and pain medicine · 2024Review
- The effect of triple-dose-intravenous tranexamic acid on blood loss in patients undergoing total hip arthroplasty without affecting blood coagulopathy: A prospective thromboelastographic analysis.Acta orthopaedica et traumatologica turcica · 2023Article
- Traumatic Brain Injuries: Comprehensive Management of Complex Clinical Scenarios.Emergency medicine international · 2023Article
Corrections and comments
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Authors and funding
23 authors at 1 institution in 1 country.
Funding
Abstract
backgroundNo Food and Drug Administration-approved medication improves outcomes following traumatic brain injury (TBI). A forthcoming clinical trial that evaluated the effects of two prehospital tranexamic acid (TXA) dosing strategies compared with placebo demonstrated no differences in thromboelastography (TEG) values. We proposed to explore the impact of TXA on markers of coagulation and fibrinolysis in patients with moderate to severe TBI.
methodsData were extracted from a placebo-controlled clinical trial in which patients 15 years or older with TBI (Glasgow Coma Scale, 3-12) and systolic blood pressure of ≥90 mm Hg were randomized prehospital to receive placebo bolus/placebo infusion (placebo), 1 g of TXA bolus/1 g of TXA infusion (bolus maintenance), or 2 g of TXA bolus/placebo infusion (bolus only). Thromboelastography was performed, and coagulation measures including prothrombin time, activated partial thromboplastin time, international ratio, fibrinogen, D-dimer, plasmin-antiplasmin (PAP), thrombin antithrombin, tissue plasminogen activator, and plasminogen activator inhibitor 1 were quantified at admission and 6 hours later.
resultsOf 966 patients receiving study drug, 700 had laboratory tests drawn at admission and 6 hours later. There were no statistically significant differences in TEG values, including LY30, between groups (p > 0.05). No differences between prothrombin time, activated partial thromboplastin time, international ratio, fibrinogen, thrombin antithrombin, tissue plasminogen activator, and plasminogen activator inhibitor 1 were demonstrated across treatment groups. Concentrations of D-dimer in TXA treatment groups were less than placebo at 6 hours (p < 0.001). Concentrations of PAP in TXA treatment groups were less than placebo on admission (p < 0.001) and 6 hours (p = 0.02). No differences in D-dimer and PAP were observed between bolus maintenance and bolus only.
conclusionWhile D-dimer and PAP levels reflect a lower degree of fibrinolysis following prehospital administration of TXA when compared with placebo in a large prehospital trial of patients with TBI, TEG obtained on admission and 6 hours later did not demonstrate any differences in fibrinolysis between the two TXA dosing regimens and placebo. LEVEL OF EVIDENCE: Diagnostic test, level III.
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