Tranexamic acid and its role in trauma-induced coagulopathies in hemodynamically unstable trauma patients in a tertiary care center in Riyadh, Saudi Arabia

Background: Trauma is the leading cause of mortality and disability in adults. Most trauma patients appear coagulopathic upon admission. Tranexamic acid (TXA) reduces bleeding, thus reducing mortality in such patients. Objectives: The objectives of the study were to compare the outcome of unstable trauma patients who received TXA versus patients who have not and to identify the effect of TXA on them. Design: It’s a retrospective cohort study, accomplished by reviewing patients’ electronic files. Setting: It is a single-center study, done in King Abdulaziz Medical City in Riyadh, Saudi Arabia. Materials and Methods: All unstable trauma patients’ who fulfilled the inclusion criteria from 2016 to 2018 were included in the study. Main Outcome Measure: The usage of TXA and its benefits on reducing mortality in trauma patients. Sample Size: A total of 215 unstable trauma patients were included in the study. Results: Our results showed that 33% of patients received TXA, while 67% did not. About 94.4% of the subjects were males. Coagulopathy occurred more among patients who received TXA. About 56.3% of the patients who required a transfusion took TXA and 16.3% of them died. About 15.5% of patients who took TXA died in the hospital in comparison to 5.6% of patients who did not. Conclusion: The administration of TXA in hemodynamically unstable trauma patients has shown to increase the incidence of coagulopathy significantly, and it revealed to be unsatisfactory in preventing mortality. Limitations: It is a single-center chart review study, so some data were missing, and thus, not all patients during that time were included. Furthermore, we lack a standard TXA protocol, so some of the results conflicted with other studies.