2E. Military TXA Studies – TXA looks good in multiple settings.

Military Studies

 Take Home: TXA seems effective in multiple settings and multiple studies.

There are several other studies evaluating TXA in a military setting. TXA does seem effective in these studies as well, but because the protocols are different and they are less applicable to our setting, I have only given basic info below.  Links are there to read on your own if you wish.



MATTERs Study – Military Application of Tranexamic Acid in Trauma Emergency Resuscitation (MATTERs) Study

 

http://archsurg.jamanetwork.com/article.aspx?articleid=1107351

Design: Retrospective observational study of 896 pts (293 given TXA) in Afghanistan.

Intervention: Bolus doses of TXA

Outcome: Mortality at 30 days from injury

Results:

  • Death in TXA: 17.4% (in a MORE severely injured cohort).
  • Death in No TXA: 23.9% 


Matters II study:

Association of Cryoprecipitate and Tranexamic Acid With Improved Survival Following Wartime Injury: Findings From the MATTERs II Study

http://archsurg.jamanetwork.com/article.aspx?articleid=1392167

Design: Prospective data registry from US and UK

Intervention: Bolus TXA or placebo +/- Cryoprecipitate

Outcome: Death 30 days after injury

Results: 1332 pts, evaluated cryoprecipitate as well.

Death % Cryoprecipitate No Cryoprecipitate
TXA 11.6% 21.4%
Placebo 18.2% 23.6%

Conclusions: While having very different protocols than are used in civilian population, TXA still seems to have significant mortality benefit in a different patient population.

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