ArticleCritical care (London, England)2021
The impact of prehospital tranexamic acid on mortality and transfusion requirements: match-pair analysis from the nationwide German TraumaRegister DGU®.
Article in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Tranexamic acid in trauma: A joint position statement and resource document of NAEMSP, ACEP, and ACS-COT.The journal of trauma and acute care surgery · 2025Guideline
- Prehospital tranexamic acid decreases early mortality in trauma patients: a systematic review and meta-analysis.Frontiers in medicine · 2025Pooled it
- Effectiveness and safety of prehospital tranexamic acid in patients with trauma: an updated systematic review and meta-analysis with trial sequential analysis.BMC emergency medicine · 2024Pooled it
- Efficacy and safety of the second in-hospital dose of tranexamic acid after receiving the prehospital dose: double-blind randomized controlled clinical trial in a level 1 trauma center.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Trial
- Adherence to strong recommendations of the German Polytrauma Guideline: an analysis of TraumaRegister DGU data over a decade.Scientific reports · 2026Article
- Tranexamic acid in multiply injured patients-the independent risk of thromboembolic complications with repeated dosing: retrospective analysis based on the TraumaRegister DGU®.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Reassessing the role of external fixation in polytrauma and severly injured patients with chest trauma and femur fracture: a propensity score-matched analysis from the TraumaRegister DGUEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Calcium supplementation during trauma resuscitation: a propensity score-matched analysis from the TraumaRegister DGUCritical care (London, England) · 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
- Review
- Trauma-induced disturbances in ionized calcium levels correlate parabolically with coagulopathy, transfusion, and mortality: a multicentre cohort analysis from the TraumaRegister DGUCritical care (London, England) · 2023Article
- Nonsurgical management of major hemorrhage.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Review
- [The chapters "Stop the bleed-prehospital" and "Coagulation management and volume therapy (emergency departement)" in the new S3 guideline "Polytrauma/severe injury treatment"].Notfall & rettungsmedizin · 2023Review
- Early identification of bleeding in trauma patients: external validation of traumatic bleeding scores in the Swiss Trauma Registry.Critical care (London, England) · 2022Article
- Study conclude that TXA in severely injured was associated with lower mortality: beware of potential confounders.Critical care (London, England) · 2021Article
- The Pathophysiology and Management of Hemorrhagic Shock in the Polytrauma Patient.Journal of clinical medicine · 2021Review
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOutcome data about the use of tranexamic acid (TXA) in civilian patients in mature trauma systems are scarce. The aim of this study was to determine how severely injured patients are affected by the widespread prehospital use of TXA in Germany.
methodsThe international TraumaRegister DGU® was retrospectively analyzed for severely injured patients with risk of bleeding (2015 until 2019) treated with at least one dose of TXA in the prehospital phase (TXA group). These were matched with patients who had not received prehospital TXA (control group), applying propensity score-based matching. Adult patients (≥ 16) admitted to a trauma center in Germany with an Injury Severity Score (ISS) ≥ 9 points were included.
resultsThe matching yielded two comparable cohorts (n = 2275 in each group), and the mean ISS was 32.4 ± 14.7 in TXA group vs. 32.0 ± 14.5 in control group (p = 0.378). Around a third in both groups received one dose of TXA after hospital admission. TXA patients were significantly more transfused (p = 0.022), but needed significantly less packed red blood cells (p ≤ 0.001) and fresh frozen plasma (p = 0.023), when transfused. Massive transfusion rate was significantly lower in the TXA group (5.5% versus 7.2%, p = 0.015). Mortality was similar except for early mortality after 6 h (p = 0.004) and 12 h (p = 0.045). Among non-survivors hemorrhage as leading cause of death was less in the TXA group (3.0% vs. 4.3%, p = 0.021). Thromboembolic events were not significantly different between both groups (TXA 6.1%, control 4.9%, p = 0.080).
conclusionThis is the largest civilian study in which the effect of prehospital TXA use in a mature trauma system has been examined. TXA use in severely injured patients was associated with a significantly lower risk of massive transfusion and lower mortality in the early in-hospital treatment period. Due to repetitive administration, a dose-dependent effect of TXA must be discussed.
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