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Background

Each year, worldwide, about 3 million people die as a result of trauma, many after reaching hospital. Among trauma patients who do survive to reach hospital, bleeding is a common cause of death, accounting for about one-third of in-hospital deaths. The antifibrinolytic tranexamic acid (TXA) has been shown to reduce blood loss in surgical patients without apparently increasing the risk of postoperative complications. Surgery and trauma trigger similar haemostatic responses. If TXA reduces deaths due to bleeding in trauma patients, this would be an important discovery.

Objective

We sought to quantify the effects of early administration of TXA on death, vascular occlusive events and the receipt of blood transfusion in trauma patients.

Methods

The Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2 (CRASH-2) trial was a randomised controlled trial carried out in 274 hospitals in 40 …