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Open Access 01-12-2024 | Tranexamic Acid | Research

Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan

Authors: Jotaro Tachino, Shigeto Seno, Hisatake Matsumoto, Tetsuhisa Kitamura, Atsushi Hirayama, Shunichiro Nakao, Yusuke Katayama, Hiroshi Ogura, Jun Oda

Published in: Critical Care | Issue 1/2024

Abstract

Background

In trauma systems, criteria for individualised and optimised administration of tranexamic acid (TXA), an antifibrinolytic, are yet to be established. This study used nationwide cohort data from Japan to evaluate the association between TXA and in-hospital mortality among all patients with blunt trauma based on clinical phenotypes (trauma phenotypes).

Methods

A retrospective analysis was conducted using data from the Japan Trauma Data Bank (JTDB) spanning 2019 to 2021.

Results

Of 80,463 patients with trauma registered in the JTDB, 53,703 met the inclusion criteria, and 8046 (15.0%) received TXA treatment. The patients were categorised into eight trauma phenotypes. After adjusting with inverse probability treatment weighting, in-hospital mortality of the following trauma phenotypes significantly reduced with TXA administration: trauma phenotype 1 (odds ratio [OR] 0.68 [95% confidence interval [CI] 0.57–0.81]), trauma phenotype 2 (OR 0.73 [0.66–0.81]), trauma phenotype 6 (OR 0.52 [0.39–0.70]), and trauma phenotype 8 (OR 0.67 [0.60–0.75]). Conversely, trauma phenotypes 3 (OR 2.62 [1.98–3.47]) and 4 (OR 1.39 [1.11–1.74]) exhibited a significant increase in in-hospital mortality.

Conclusions

This is the first study to evaluate the association between TXA administration and survival outcomes based on clinical phenotypes. We found an association between trauma phenotypes and in-hospital mortality, indicating that treatment with TXA could potentially influence this relationship. Further studies are needed to assess the usefulness of these phenotypes.

Graphical abstract

Available only for authorised users

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Title: Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan
Authors: Jotaro Tachino
Shigeto Seno
Hisatake Matsumoto
Tetsuhisa Kitamura
Atsushi Hirayama
Shunichiro Nakao
Yusuke Katayama
Hiroshi Ogura
Jun Oda
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Tranexamic Acid
Published in: Critical Care / Issue 1/2024
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-024-04871-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

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