Michelle Ng1, Jerrold Perrott2, Sarah Burgess3. 1. St. Paul's Hospital, 1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada. Electronic address: michelle.ng@fraserhealth.ca. 2. Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BC V5Z 1M9, Canada. Electronic address: jerrold.perrott@vch.ca. 3. Nova Scotia Health Authority, Halifax, NS, Canada. Electronic address: sarah.burgess@nshealth.ca.
Abstract
INTRODUCTION: Tranexamic acid (TXA) has been shown to decrease mortality in adult trauma patients with or at significant risk of hemorrhage when administered within 3 h of injury. The use and appropriateness of TXA in adult trauma patients presenting to Royal Columbian Hospital (RCH) was investigated. METHODS: This retrospective chart review utilized the British Columbia Trauma Registry to identify 100 consecutive trauma patients that presented to the emergency department at RCH between April 2012 to June 2015 and met the following indications for TXA: systolic blood pressure <90 mm Hg and/or heart rate >110 bpm and presentation within 8 h of injury. Primary outcomes included: percentage that met indications for TXA, received TXA according to the CRASH-2 protocol, received a pre-hospital dose, and received TXA ≤1, >1 to ≤3, or >3 h from injury. RESULTS: During the given time period, 117 subjects (2.7%) met indications for TXA. 67 patients (57%) received TXA in any dose, with 10 subjects (8.5%) receiving TXA according to the CRASH-2 protocol. Of the 67 patients who received any TXA, 76% did so ≤3 h. 22 patients (19%) received TXA as a pre-hospital dose. CONCLUSIONS: <10% of adult trauma patients that met the indication for TXA received it according to the CRASH-2 protocol. Of those patients that received TXA, 76% did so within 3 h. Further inquiry to identify reasons trauma patients are not receiving TXA as well as quality improvement initiatives in trauma care are required. LEVEL OF EVIDENCE: III STUDY TYPE: Therapeutic.
INTRODUCTION:Tranexamic acid (TXA) has been shown to decrease mortality in adult traumapatients with or at significant risk of hemorrhage when administered within 3 h of injury. The use and appropriateness of TXA in adult traumapatients presenting to Royal Columbian Hospital (RCH) was investigated. METHODS: This retrospective chart review utilized the British Columbia Trauma Registry to identify 100 consecutive traumapatients that presented to the emergency department at RCH between April 2012 to June 2015 and met the following indications for TXA: systolic blood pressure <90 mm Hg and/or heart rate >110 bpm and presentation within 8 h of injury. Primary outcomes included: percentage that met indications for TXA, received TXA according to the CRASH-2 protocol, received a pre-hospital dose, and received TXA ≤1, >1 to ≤3, or >3 h from injury. RESULTS: During the given time period, 117 subjects (2.7%) met indications for TXA. 67 patients (57%) received TXA in any dose, with 10 subjects (8.5%) receiving TXA according to the CRASH-2 protocol. Of the 67 patients who received any TXA, 76% did so ≤3 h. 22 patients (19%) received TXA as a pre-hospital dose. CONCLUSIONS: <10% of adult traumapatients that met the indication for TXA received it according to the CRASH-2 protocol. Of those patients that received TXA, 76% did so within 3 h. Further inquiry to identify reasons traumapatients are not receiving TXA as well as quality improvement initiatives in trauma care are required. LEVEL OF EVIDENCE: III STUDY TYPE: Therapeutic.
Authors: Péter Jávor; Lilla Hanák; Péter Hegyi; Endre Csonka; Edina Butt; Tamara Horváth; István Góg; Anita Lukacs; Alexandra Soós; Zoltán Rumbus; Eszter Pákai; János Toldi; Petra Hartmann Journal: BMJ Open Date: 2022-10-19 Impact factor: 3.006
Authors: Mahdi Al-Jeabory; Lukasz Szarpak; Kecskes Attila; Michael Simpson; Adam Smereka; Aleksandra Gasecka; Wojciech Wieczorek; Michal Pruc; Maciej Koselak; Wladyslaw Gawel; Igor Checinski; Milosz J Jaguszewski; Krzysztof J Filipiak Journal: J Clin Med Date: 2021-03-03 Impact factor: 4.241