Background: The use of tranexamic acid (TXA) has become increasingly prevalent for hemorrhage prevention in military trauma patients due to its known survival benefits. There is concern of increased venous thromboembolism (VTE) subsequent to receiving TXA. The purpose of this retrospective study was to determine the rate of VTE in severely injured military personnel during Operation Enduring Freedom (2009-2014).
Methods: An analysis of 859 military trauma patients from the 2009-2014 Department of Defense Trauma Registry included subjects with an injury severity score (ISS) >10 and a massive transfusion (MT) (>10 units of blood products in the first 24 hours). Outcomes included a documented VTE (eg, deep vein thrombosis (DVT) or pulmonary embolism (PE)) during the patient's hospital course. Comparison between those who did/did not receive TXA was analyzed using three separate multiple regression analyses using listwise deletion, systematic replacement and multiple imputation.
Results: Subjects (n=620) met inclusion criteria with 27% (n=169) having a documented VTE. A total of 30% that received TXA had a documented VTE, 26% that did not receive TXA had a documented VTE and 43% (n=264, n=620) of the sample did not have TXA documented as either given or not given. Multiple regression analyses using listwise deletion and systematic replacement of the TXA variable demonstrated no difference in odds of VTE, whereas the multiple imputation analysis demonstrated a 3% increased odds of VTE, a9.4% increased odds of PE and 8.1% decreased odds of DVT with TXA administration.
Discussion: TXA use with an ISS >10 and MT resuscitation had a 3% increased odds of VTE and an increased odds of PE, whereas the odds of DVT were found to be decreased after multiple imputation analysis. Further research on the long-term risks and benefits of TXA usage in the military population is recommended.
Level Of Evidence: IV-therapeutic.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996783 | PMC |
| http://dx.doi.org/10.1136/tsaco-2019-000353 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Lessons learned from setting up a hospital-based national registry for venous thromboembolic disorders in India.
J Family Med Prim Care
November 2024
Non-Communicable Diseases, Division, Indian Council of Medical Research, New Delhi, India.
Introduction: Health registries are instrumental in tracking trends in the number of people with diseases, monitoring treatment options, and assessing health outcomes. This research examines the challenges of establishing and maintaining a venous thromboembolism (VTE) registry in the Indian context.
Methods: A mixed-method approach with purposive sampling was conducted to capture the challenges faced by individuals playing key roles in the establishment and operation of the national registry on VTE.
Safety Assessment of Cyanoacrylate Closure for Treatment of Varicose Veins in a Large-Scale National Survey in Japan.
J Vasc Surg Venous Lymphat Disord
December 2024
Department of Cardiovascular Surgery, Fukushima Dai-Ichi Hospital, Fukushima, Japan; Japanese Regulatory Committee for Endovascular Treatment of Varicose Veins.
Objective: Cyanoacrylate closure (CAC) is a minimally invasive technique for treating axial venous reflux. However, the incidence of serious adverse events (AEs) related to CAC is concerning. With an increasing number of patients receiving CAC and insufficient safety data in Japan, this study aimed to investigate the safety profile of CAC, focusing on the types and incidence of AEs.
View Article and Find Full Text PDFThrombotic Risk Assessment, P-Selectin, and Thromboprophylaxis Use Among, Cancer Patients at the University of Calabar Teaching Hospital, Calabar.
J Blood Med
December 2024
Department of Pathology, Kampala International University Western Campus, Ishaka, Uganda.
Article Synopsis
- Venous thromboembolism (VTE) is a major cause of death in cancer patients, and the modified Khorana Risk Assessment Score (KRAS) is considered the top tool for assessing this risk.
- The study aimed to evaluate VTE risk among 100 cancer patients at the University of Calabar Teaching Hospital, analyzing their KRAS scores, soluble P-selectin levels, and thromboprophylaxis use.
- Results showed a significant number of participants at intermediate to high VTE risk, highlighting a lack of adherence to the Khorana score and underutilization of preventive measures in clinical practice.
Aim Effective documentation of critical clinical information is vital for patient safety and timely discharges. Ward rounds (WRs) are crucial for multidisciplinary assessments and care planning. Current emergency surgical WR documentation is inconsistent; therefore, this study will implement a structured WR template adapted from the Royal College of Surgeons of Edinburgh's "Surgical Assessment for Emergencies Ward Round Tool" (SAFE) to address these shortcomings.
View Article and Find Full Text PDFVENOUS THROMBOEMBOLISM RISK ASSESSMENT IN HOSPITALISED PATIENTS IN A TERTIARY CARE HOSPITAL IN PAKISTAN.
J Ayub Med Coll Abbottabad
November 2024
Rawalpindi Institute of Cardiology, Rawalpindi-Pakistan.
Article Synopsis
- Venous thromboembolism (VTE) is a major health issue, particularly affecting the elderly, leading to high recurrence rates and increased healthcare costs, prompting the study to assess the impact of a VTE risk assessment tool and thromboprophylaxis in hospitalized patients.
- Conducted in a tertiary hospital in Pakistan, the study evaluated 1,200 adult inpatients, finding that only 15.83% of medical records documented a VTE risk assessment, and thromboprophylaxis was prescribed to just 37.5% of patients.
- The findings highlight that many hospitalized patients are at high risk for VTE, primarily due to old age, yet the implementation of VTE risk assessments and the use of
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!