Wider use of tranexamic acid to reduce surgical bleeding could benefit patients and health systems

Major bleeding during surgery is common and is an important cause of surgical deaths.1 Each year, worldwide, over 300 million people have major surgery, and around four million die within 30 days of the operation.2 In the UK, there are eight million surgical procedures each year with about 85 000 deaths within 30 days.3 Major bleeding is strongly associated with mortality, accounting for the largest share of deaths.1 Transfusion can be lifesaving, but blood is a scarce resource and transfusion has risks. The strong evidence that tranexamic acid safely reduces surgical bleeding and the need for blood transfusion therefore has important implications for patient care, not only in the UK but worldwide.In the UK the National Institute for Health and Care Excellence (NICE) made the use of tranexamic acid for adults who are having surgery and expected to have “moderate (>500 ml) blood loss” a quality standard in 2016.4 However,…
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