metricas
covid
Buscar en
Revista Española de Anestesiología y Reanimación (English Edition)
Toda la web
Inicio Revista Española de Anestesiología y Reanimación (English Edition) Tranexamic acid in patients with traumatic brain injury: a meta-analysis
Journal Information
Vol. 71. Issue 5.
Pages 360-367 (May 2024)
Share
Share
Download PDF
More article options
Vol. 71. Issue 5.
Pages 360-367 (May 2024)
Original article
Tranexamic acid in patients with traumatic brain injury: a meta-analysis
Efecto del ácido tranexámico en sujetos con lesión cerebral traumática: metaanálisis
R.M. Sarhan, M.S. Boshra, M.E.A. Abdelrahim
Corresponding author
mohamedemam9@yahoo.com

Corresponding author.
, H. Osama
Departamento de Farmacia Clínica, Facultad de Farmacia, Universidad Beni-Suef, Beni-Suef, Egypt
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (7)
Show moreShow less
Additional material (1)
Abstract
Background

We performed a meta-analysis to assess the effectiveness and safety of tranexamic acid in patients with traumatic brain injury (TBI).

Methods

We searched the literature for articles evaluating the effectiveness and safety of tranexamic acid (TXA) in TBI published between January 2012 and January 2021, and identified 8 studies with a total of 10860 patients: 5660 received TXA and 5200 served as controls. We used a dichotomous or continuous approach with a random or fixed-effect model to assess the efficacy and safety of TXA in TBI, and calculated the mean difference (MD) and odds ratio (OR) with the corresponding 95% confidence interval.

Results

In patients with TBI, early administration of TXA was associated with a greater relative benefit (MD −2.45; 95% CI = −4.78 to −0.12; p=0.04) and less total haematoma expansion (MD - 2.52; 95% CI = −4.85 to −0.19; p=0.03) compared to controls.

There were no statistically significant differences in mortality (OR 0.94; 95% CI=0.85–1.03; p=0.18), presence of progressive haemorrhage (OR 0.75; 95% CI=0.56–1.01; p=0.06), need for neurosurgery (OR 1.15; 95% CI=0.66–1.98; p=0.63), high Disability Rating Scale score (OR 0.90; 95% CI=0.56–1.45; p=0.68), and incidence of ischaemic or thromboembolic complications (OR 1.34; 95% CI=0.33–5.46; p=0.68) between TBI patients treated with TXA and controls.

Conclusions

Early administration of TXA in TBI patients may have a greater relative benefit and may inhibit haematoma expansion. There were no significant differences in mortality, presence of progressive haemorrhage, need for neurosurgery, high Disability Rating Scale score, and incidence of ischaemic or thromboembolic complications between TBI patients treated with TXA and controls. Further studies are needed to validate these results.

Keywords:
Tranexamic acid
Anti-fibrinolytic agent
Traumatic brain injury
Haemorrhage
Mortality
Meta-analysis
Resumen
Introducción

Realizamos un metaanálisis para evaluar la efectividad y seguridad del ácido tranexámico (ATX) en sujetos con lesión cerebral traumática (TBI).

Métodos

Efectuamos una búsqueda minuciosa en la literatura, de enero de 2012 a enero de 2021, e identificamos ocho estudios con un total de 10.860 pacientes al inicio del ensayo: 5.660 recibieron ATX y 5.200 actuaron de controles. Los artículos trataban de la eficacia y seguridad del ATX en los sujetos con TBI. A fin de calcular la diferencia media (DM) y odds ratio (OR) con el correspondiente 95% de intervalo de confianza (IC), utilizamos un enfoque dicotómico o continuo con un modelo de efecto aleatorio o fijo.

Resultados

El ATX estuvo ligado a una mayor ventaja relativa de la inclusión temprana en las personas con TBI (DM −2,45; IC 95% = −4,78 a −0,12; p=0,04) y a un menor crecimiento total de la lesión hemorrágica (MD, −2,52; IC 95% = −4,85 a −0,19, p=0,03), en comparación con los controles.

Por otro lado, no existió varianza significativa en términos de mortalidad entre los grupos de ATX y control en los sujetos con TBI (OR 0,94; IC 95%=0,85-1,03; p=0,18), hemorragia progresiva (OR 0,75; IC 95%=0,56−1,01; p=0,06), necesidad de neurocirugía (OR 1,15; IC 95%=0,66−1,98; p=0,63), puntuación desfavorable de Disability Rating Scale (DRS) (OR 0,90; IC 95%=0,56−1,45; p=0,68), e incidencia de complicaciones isquémicas o tromboembólicas (OR 1,34; IC 95%=0,33−5,46; p=0,68).

Conclusiones

El ATX en los sujetos con TBI puede tener un mayor beneficio relativo en cuanto a inicio temprano y menor crecimiento de la lesión hemorrágica en comparación con el grupo control. Por el contrario, no existieron diferencias significativas en los grupos de ATX y control en los pacientes con TBI con respecto a la mortalidad, hemorragia progresiva, necesidad de neurocirugía, puntuación desfavorable de DRS e incidencia de complicaciones isquémicas o tromboembólicas Son necesarios estudios adicionales para validar estos resultados.

Palabras clave:
Ácido tranexámico
Agente antifibrinolítico
Lesión cerebral traumática
Hemorragia
Mortalidad
Metaanálisis

Article

These are the options to access the full texts of the publication Revista Española de Anestesiología y Reanimación (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Española de Anestesiología y Reanimación (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos