Login
Site Search
Trauma-List Subscription

Subscribe

Would you like to receive list emails batched into one daily digest?
No Yes
Modify Your Subscription

Modify

Home > List Archives

FW: In the words of Queen...

Jarek jarekgucwa at gmail.com
Fri May 15 08:05:27 BST 2015


Life circles. Back to the starting positions like with other miracuolous
agents

Jarek Gucwa
15 maj 2015 08:48 "Timothy Hardcastle" <Hardcastle at ukzn.ac.za> napisał(a):

> Hi all
>
> This one came across my desk. Admittedly only got the abstract for
> now….but makes me wonder. More study needed me thinks.
>
>
> The impact of tranexamic acid on mortality in injured patients with
> hyperfibrinolysis<
> http://journals.lww.com/jtrauma/Abstract/2015/05000/The_impact_of_tranexamic_acid_on_mortality_in.2.aspx
> >
>
> Harvin, John A.; Peirce, Charles A.; Mims, Mark M.; Hudson, Jessica A.;
> Podbielski, Jeanette M.; Wade, Charles E.; Holcomb, John B.; Cotton, Bryan
> A. Less
>
> Abstract:
>
> BACKGROUND: In 2011, supported by data from two separate trauma centers,
> we implemented a protocol to administer tranexamic acid (TXA) in trauma
> patients with evidence of hyperfibrinolysis (HF) on admission. The purpose
> of this study was to examine whether the use of TXA in patients with HF
> determined by admission rapid thrombelastography was associated with
> improved survival.
>
> METHODS: Following institutional review board approval, we evaluated all
> trauma patients 16 years or older admitted between September 2009 and
> September 2013. HF was defined as LY-30 of 3% or greater. Patients with
> LY-30 less than 3.0% were excluded. Patients were divided into those who
> received TXA (TXA group) and those who did not (no-TXA group). After
> univariate analyses, a purposeful, logistic regression model was developed
> a priori to evaluate the impact of TXA on mortality (controlling for age,
> sex, Injury Severity Score (ISS), arrival physiology, and base deficit).
>
> RESULTS: A total of 1,032 patients met study criteria. Ninety-eight (10%)
> received TXA, and 934 (90%) did not. TXA patients were older (median age,
> 37 years vs. 32 years), were more severely injured (median ISS, 29 vs. 14),
> had a lower blood pressure (median systolic blood pressure 103 mm Hg vs.
> 125 mm Hg), and were more likely to be in shock (median, base excess, −5
> mmol/dL vs. -2 mmol/dL), all p < 0.05. Twenty-three percent of the patients
> had a repeat thrombelastography within 6 hours; 8.8% of the TXA patients
> had LY-30 of 3% or greater on repeat rapid thrombelastography (vs. 10.1% in
> the no-TXA group, p = 0.679). Unadjusted in-hospital mortality was higher
> in the TXA group (40% vs. 17%, p < 0.001). There were no differences in
> venous thromboembolism (3.3% vs. 3.8%). Logistic regression failed to find
> a difference in in-hospital mortality among those receiving TXA (odds
> ratio, 0.74; 95% confidence interval, 0.38–1.40; p 0.80).
>
> CONCLUSION: In the current study, the use of TXA was not associated with a
> reduction in mortality. Further studies are needed to better define who
> will benefit from an administration of TXA.
>
> LEVEL OF EVIDENCE: Therapeutic study, level IV.
>
> Regards,
> Tim
> Dr Timothy Hardcastle
> MB,ChB(Stell); M.Med(Chir)(Stell); PhD, FCS(SA), Trauma Surgery(HPCSA)
> Head: UKZN Trauma Surgery Training Unit
> Deputy Director: IALCH Trauma Service and Trauma ICU
> Hardcastle at ukzn.ac.za<mailto:Hardcastle at ukzn.ac.za> /
> timothyhar at ialch.co.za<mailto:timothyhar at ialch.co.za>
> Mobile +27824681615
> Postal: PostNet 27, Private Bag X05, MALVERN, 4055
> Durban, South Africa
>
>
>
>
> …………and another one bites the dust.
>
> Prof
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/


More information about the trauma-list mailing list