Abstract
To conduct a systematic review and meta-analysis and evaluate the effect of tranexamic acid in patients with traumatic brain injury. PubMed, EMBASE, and CENTRAL (Cochrane Central Register of Controlled Trials) were searched to identify randomized controlled trials and evaluate the effect of tranexamic acid in traumatic brain injury patients. The primary outcome was mortality. Two reviewers extracted the data independently. The random effect meta-analysis was used to estimate the aggregate effect size of 95% confidence intervals. Six randomized controlled trials investigating tranexamic acid versus placebo and 30073 patients were included. Compared with placebo, tranexamic acid decreased the mortality (RR = 0.92; 95% CI, 0.87–0.96; p < 0.001) and growth of hemorrhagic mass (RR = 0.78; 95% CI, 0.61–0.99; p = 0.04). However, tranexamic acid could not decrease disability or independent, neurosurgery, vascular embolism, and stroke. Current evidence suggested that compared with placebo, tranexamic acid could reduce mortality and growth of hemorrhagic mass. This finding indicated that patients with traumatic brain injury should be treated with tranexamic acid.
Highlights
Every year, it was estimated that more than 60 million individuals suffer from traumatic brain injury (TBI) all over the world for a variety of reasons [1]
Study indicated that intracranial hemorrhage was a common complication of TBI, which increased the risk of death and disability [2]
In order to provide the latest and most convincing evidence, we systematically reviewed the existing literature to study whether Tranexamic acid (TXA) could reduce the mortality of patients with TBI
Summary
It was estimated that more than 60 million individuals suffer from traumatic brain injury (TBI) all over the world for a variety of reasons [1]. The secondary objective was to evaluate the effects of TXA on disability or independent, vascular embolism (including myocardial infarction, deep vein thrombosis, and pulmonary embolism), and stroke in TBI patients. The inclusion criteria were as follows: (1) population: patients with TBI; (2) intervention: TXA (1 g in 100 ml of normal saline); (3) comparison: placebo; (4) outcome: the primary outcome was mortality, the second outcomes included disability or independent, growth of hemorrhagic mass, neurosurgery, vascular embolism (including myocardial infarction, deep vein thrombosis, and pulmonary embolism) and stroke; and (5) design: RCTs. VTA was administered as soon as possible, with a first dose of 1 g in 100 ml of normal saline in 10 min and with a maintenance dose of 1 g per 500 ml of normal saline for 8 h
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