Trial reportHealth technology assessment (Winchester, England)2021
Tranexamic acid to reduce head injury death in people with traumatic brain injury: the CRASH-3 international RCT.
Trial report in Health technology assessment (Winchester, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 12 papers, 2 of them syntheses that pooled 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.
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.
Tranexamic Acid for the Treatment of Significant Traumatic Brain Injury: an International Randomised, Double Blind Placebo Controlled Trial
TRACE STUDY: A Randomized Controlled Trial Using Tranexamic Acid in the Treatment of Subdural Hematoma
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Blood transfusion strategies for major bleeding in trauma.The Cochrane database of systematic reviews · 2025Pooled it
- The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition.Critical care (London, England) · 2023Guideline
- Phytochemical Nanoparticles for the Treatment of Neurological Disorders.Phytochemical analysis : PCA · 2025Review
- Application and research progress of tranexamic acid in the perioperative period of posterior lumbar interbody fusion.Frontiers in medicine · 2025Review
- Review
- Population pharmacokinetic modelling and simulation of tranexamic acid in adult trauma patients.British journal of clinical pharmacology · 2024Article
- A Modern Approach to the Treatment of Traumatic Brain Injury.Medicines (Basel, Switzerland) · 2024Review
- Association between nutritional status, injury severity, and physiological responses in trauma patients.Frontiers in physiology · 2024Article
- Effects of decompressive craniectomy combined with edaravone on postoperative neurological functions and hemodynamics of patients with severe traumatic brain injury.Neurosciences (Riyadh, Saudi Arabia) · 2024Article
- Does tranexamic acid have a positive effect on the outcome of older multiple trauma patients on antithrombotic drugs? An analysis using the TraumaRegister DGUFrontiers in medicine · 2024Article
- [Traumatic brain injury].Der Nervenarzt · 2023Article
- The efficacy of tranexamic acid treatment with different time and doses for traumatic brain injury: a systematic review and meta-analysis.Thrombosis journal · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundTranexamic acid safely reduces mortality in traumatic extracranial bleeding. Intracranial bleeding is common after traumatic brain injury and can cause brain herniation and death. We assessed the effects of tranexamic acid in traumatic brain injury patients.
objectiveTo assess the effects of tranexamic acid on death, disability and vascular occlusive events in traumatic brain injury patients. We also assessed cost-effectiveness.
designRandomised trial and economic evaluation. Patients were assigned by selecting a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients, caregivers and those assessing outcomes were masked to allocation. All analyses were by intention to treat. We assessed the cost-effectiveness of tranexamic acid versus no treatment from a UK NHS perspective using the trial results and a Markov model.
setting175 hospitals in 29 countries.
participantsAdults with traumatic brain injury within 3 hours of injury with a Glasgow Coma Scale score of ≤ 12 or any intracranial bleeding on computerised tomography scan, and no major extracranial bleeding, were eligible.
interventionTranexamic acid (loading dose 1 g over 10 minutes then infusion of 1 g over 8 hours) or matching placebo.
main outcome measuresHead injury death in hospital within 28 days of injury in patients treated within 3 hours of injury. Secondary outcomes were early head injury deaths, all-cause and cause-specific mortality, disability, vascular occlusive events, seizures, complications and adverse events.
resultsAmong patients treated within 3 hours of injury (
conclusionEarly tranexamic acid treatment reduces head injury deaths. Treatment is cost-effective for patients with mild or moderate traumatic brain injury, or those with both pupils reactive. FUTURE WORK: Further trials should examine early tranexamic acid treatment in mild head injury. Research on alternative routes of administration is needed. LIMITATIONS: Time to treatment may have been underestimated.
trial registrationCurrent Controlled Trials ISRCTN15088122, ClinicalTrials.gov NCT01402882, EudraCT 2011-003669-14, Pan African Clinical Trial Registry PACTR20121000441277.
fundingThe project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in
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What OpenQuestion holds
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.