Tranexamic Acid for Traumatic Brain Injury.

Abstract

Traumatic brain injury (TBI) is a significant cause of morbidity and mortality. In 2014, there were approximately 2.5 million emergency department visits for TBI in the United States, with 56,800 deaths attributed directly to TBI.1 Among survivors it is estimated millions more live with long-term disability.2 While one large study demonstrates a mortality benefit (NNT=67) for tranexamic acid (TXA) in multi-system trauma,3 no primary outcome benefit was demonstrated for TXA in the WOMAN trial4 of post-partum hemorrhage or in the HALT-IT trial5 of gastrointestinal bleeding. Here we summarize results from the CRASH-3 trial,6 as well as from a systematic review combining this trial with data from 6 smaller trials of TXA for TBI.7.