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
Design: Retrospective observational study of 896 pts (293 given TXA) in Afghanistan.
Intervention: Bolus doses of TXA
Outcome: Mortality at 30 days from injury
- 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
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|
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.