Evidence map›Paper›PMID 37258083›Full record

SynthesisBMJ open2023

Factors that influence the administration of tranexamic acid (TXA) to trauma patients in prehospital settings: a systematic review.

Helen Nicholson, Natalie Scotney, Simon Briscoe, Kim Kirby, Adam Bedson, Laura Goodwin, Maria Robinson, Hazel Taylor, Jo Thompson Coon, Sarah Voss and 1 more

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.9field-weighted citation impact, top 15% 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

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 3 countries.

Helen NicholsonCollege of Health, Science and Society, University of the West of England, Bristol, UK helen5.nicholson@uwe.ac.uk.ORCID 0000-0002-8964-0607
Natalie ScotneyResearch, Audit and Quality Improvement Department, South Western Ambulance Service NHS Foundation Trust, Exeter, UK.
Simon BriscoeExeter HS&DR Evidence Synthesis Centre, University of Exeter Medical School, Exeter, UK.
Kim KirbyResearch, Audit and Quality Improvement Department, South Western Ambulance Service NHS Foundation Trust, Exeter, UK.
Adam BedsonResearch, Audit and Quality Improvement Department, South Western Ambulance Service NHS Foundation Trust, Exeter, UK.
Laura GoodwinCollege of Health, Science and Society, University of the West of England, Bristol, UK.ORCID 0000-0002-9118-4620
Maria RobinsonResearch, Audit and Quality Improvement Department, South Western Ambulance Service NHS Foundation Trust, Exeter, UK.ORCID 0000-0002-6978-8575
Hazel TaylorResearch Design Service, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
Jo Thompson CoonNIHR CLAHRC South West Peninsula, University of Exeter, Exeter, UK.ORCID 0000-0002-5161-0234
Sarah VossCollege of Health, Science and Society, University of the West of England, Bristol, UK.ORCID 0000-0001-5044-5145
Jonathan Richard BengerCollege of Health, Science and Society, University of the West of England, Bristol, UK.
University of the West of England · GBSouth Western Ambulance Service NHS Foundation Trust · GBUniversity of Exeter · GBUniversity Hospitals Bristol NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveIn the UK there are around 5400 deaths annually from injury. Tranexamic acid (TXA) prevents bleeding and has been shown to reduce trauma mortality. However, only 5% of UK major trauma patients who are at risk of haemorrhage receive prehospital TXA. This review aims to examine the evidence regarding factors influencing the prehospital administration of TXA to trauma patients.

designSystematic literature review. DATA SOURCES: AMED, CENTRAL, CINAHL, Cochrane Database of Systematic Reviews, Conference Proceedings Citation Index-Science, Embase and MEDLINE were searched from January 2010 to 2020; searches were updated in June 2022. CLINICALTRIALS: gov and OpenGrey were also searched and forward and backwards citation chasing performed. ELIGIBILITY CRITERIA: All primary research reporting factors influencing TXA administration to trauma patients in the prehospital setting was included. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers performed the selection process, quality assessment and data extraction. Data were tabulated, grouped by setting and influencing factor and synthesised narratively.

resultsTwenty papers (278 249 participants in total) were included in the final synthesis; 13 papers from civilian and 7 from military settings. Thirteen studies were rated as 'moderate' using the Effective Public Health Practice Project Quality Assessment Tool. Several common factors were identified: knowledge and skills; consequences and social influences; injury type (severity, injury site and mechanism); protocols; resources; priorities; patient age; patient sex.

conclusionsThis review highlights an absence of high-quality research. Preliminary evidence suggests a host of system and individual-level factors that may be important in determining whether TXA is administered to trauma patients in the prehospital setting. FUNDING AND REGISTRATION: This review was supported by Research Capability Funding from the South Western Ambulance Service NHS Foundation Trust and the National Institute for Health Research Applied Research Collaboration South West Peninsula. PROSPERO REGISTRATION NUMBER: CRD42020162943.

Indexed as

Antifibrinolytic AgentsEmergency Medical ServicesTranexamic AcidHemorrhageHumansAntifibrinolytic AgentsTranexamic AcidACCIDENT & EMERGENCY MEDICINESystematic ReviewTRAUMA MANAGEMENT

Identifiers

PMID37258083
PMCPMC10255319
OpenAlexW4378906890

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.