Tom Nolan’s research reviews—29 June 2023

Tranexamic acid after major trauma“It is hard to imagine that doctors or paramedics would withhold a treatment that saves lives in the short term because survivors may be severely disabled at six months,” say the authors of an editorial linked to new research. A randomised trial set in Australia recruited 1310 adults with major trauma who had a high risk of trauma induced coagulopathy according to the seven-point COAST score. Six months after prehospital treatment with tranexamic acid or placebo, there was no difference in survival with a favourable outcome (moderate to no disability) between the two arms of the trial (53.7% v 53.5% respectively). A secondary outcome of death at 28 days found a benefit from tranexamic acid: 17.3% versus 21.8%. The linked editorial, quoted above, reminds us that “disability is not a constant characteristic of a person, but the result of an interaction between the person and the…
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