EARLY ADMINISTRATION OF TRANEXAMIC ACID WAS ASSOCIATED TO LOWER IN-HOSPITAL MORTALITY IN TRAUMA PATIENTS IN JAPAN-A PROPENSITY SCORE ANALYSIS

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  • SHIRAISHI Atsushi
    Trauma and Acute Critical Care Medical Center, Tokyo Medical and Dental University hospital of Medicine
  • KUSHIMOTO Shigeki
    Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine
  • OTOMO Yasuhiro
    Trauma and Acute Critical Care Medical Center, Tokyo Medical and Dental University hospital of Medicine
  • SAITOH Daizoh
    Division of Traumatology, Research Institute, National Defense Medical College
  • MURATA Kiyoshi
    Trauma and Acute Critical Care Medical Center, Tokyo Medical and Dental University hospital of Medicine
  • HAYAKAWA Mineji
    Emergency and Critical Care Center, Hokkaido University Hospital
  • UEJIMA Toshifumi
    Department of Emergency and Critical Care Medicine, Kinki University Faculty of Medicine
  • KANEKO Naoyuki
    Emergency and Critical Care Center, Fukaya Red Cross Hospital
  • HAGIWARA Akiyoshi
    Department of Emergency Medicine and Critical Care, National Center For Global Health and Medicine
  • SASAKI Junichi
    Department of Emergency & Critical Care Medicine, Keio University School of Medicine
  • OGURA Hiroshi
    Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine
  • MATSUOKA Tetsuya
    Senshu Trauma and Critical Care Center Rinku General Medical Center
  • MORIMURA Naoto
    Department of Emergency Medicine, Yokohama City University Graduate School of Medicine
  • ISHIKURA Hiroyasu
    Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University
  • TAKEDA Munekazu
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • KATO Hiroshi
    Department of Critical Care and Traumatology, National Hospital Organization Disaster Medical Center
  • YOKOTA Hiroyuki
    Department of Emergency & Critical Care Medicine, Nippon Medical School
  • SAKAMOTO Teruo
    Department of Emergency and Critical Care Medicine, Kurume University School of Medicine
  • TANAKA Hiroshi
    Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital
  • KUDO Daisuke
    Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine
  • KANEMURA Takashi
    Department of Critical Care and Traumatology, National Hospital Organization Disaster Medical Center
  • SHIBUSAWA Takayuki
    Department of Emergency & Critical Care Medicine, Keio University School of Medicine
  • HAGIWARA Yasushi
    Senshu Trauma and Critical Care Center Rinku General Medical Center
  • FURUGORI Shintaro
    Department of Emergency Medicine, Yokohama City University Graduate School of Medicine
  • NAKAMURA Yoshihiko
    Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University
  • MAEKAWA Kunihiko
    Emergency and Critical Care Center, Hokkaido University Hospital
  • MAYAMA Gou
    Department of Emergency Medicine and Critical Care, National Center For Global Health and Medicine
  • YAGUCHI Arino
    Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University
  • KIM Shiei
    Department of Emergency & Critical Care Medicine, Nippon Medical School
  • TAKASU Osamu
    Department of Emergency and Critical Care Medicine, Kurume University School of Medicine
  • NISHIMURA Kazutaka
    Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital

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Other Title
  • トラネキサム酸の早期投与は日本の外傷診療においても外傷死を減少させていた－傾向スコア解析による検討

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<p>　　Background : A randomized controlled trial suggested that tranexamic acid for bleeding trauma patients reduce mortality, however, many criticisms aroused. The study objective was to assess effects of tranexamic acid on mortality and amounts of blood transfusion based on actual trauma practice in Japan. Methods : From registered trauma subjects in J-OCTET, a propensity score matching analysis selected baseline-characteristics adjusted subjects with or without tranexamic acid administration within 3 hours from injury. Intergroup comparison estimated difference in 28-day mortality and amount of blood transfusion. Results : Out of a total of 796 subjects registered in J-OCTET, propensity score matching selected 242 and 242 subjects with or without tranexamic acid administration, respectively. Twenty-eight-day mortality was lower in subjects with tranexamic acid (12.7% versus 20.6%, mean difference of -7.9% 95% confident interval [-14.2, -1.6]). No significant differences were observed in mean amount of packed red blood cell transfusion within 24 hours (4.2 units versus 3.8 units, mean difference of 0.4 units, 95% confident interval [-1.1, 2.1]) or fresh frozen plasma (4.3 units versus 3.4 units, mean difference of 0.9 units, 95% confident interval [-0.4, 3.1]). Conclusion : This observational study reproducibly demonstrated an association of decreased 28-day mortality and tranexamic acid administration within 3 hours from injury.</p>

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