Tranexamic Acid Following Injury—How Does It Work and Who Should We Be Giving It To?

Presenter: Dr. Shimena Li (advisors: Drs. Jason Sperry/Linwah Yip)

Tranexamic acid (TXA) following injury has been shown to improve survival after arrival to definitive care. Additionally, the timing of TXA administration during the in-hospital phase of case is associated with differential efficacy and safety outcomes. Recent randomized clinical trials demonstrate the safety of prehospital TXA across a spectrum of injury types and severity, but did not result in statistically significant differences in primary outcomes across treatment arms. Thus, the most appropriate injured patient population and the timing of TXA administration to maximize outcome benefits remain poorly characterized. Dr. Li will discuss findings from a secondary analysis of the STAAMP trial which showed that early (within one hour from injury) prehospital TXA following injury in patients with evidence of shock is associated with a 30-day survival benefit. She will also present plans for translational projects from the STAAMP trial in an effort to elucidate TXA’s mechanism of action and correlation with clinical outcomes in the trauma setting. Lastly, she will briefly review a modified Delphi procedure used to determine consensus Current Procedural Terminology codes relevant to source control procedures and potential applications of this tool.