THE EFFECT OF TRANEXAMIC ACID ON SURVIVAL RATE AFTER SEVERE ISOLATED TRAUMATIC BRAIN INJURY-A PROPENSITY SCORE ANALYSIS

Abstract

　　Background : The effect of tranexamic acid (TXA) on survival in patients with brain injury is still unknown. The aim of this study is to clarify the effect of TXA on survial in patients with severe isolated traumatic brain injury. Materials and methods : Data were collected from J-OCTET database and the missing values were complemented with multiple imputation method, thus creating 101 data sets. Severe isolated traumatic brain injury was defined as follows : AIS score of head and neck with 4, 5 or 6, and injury to other parts of the body with AIS score of less than 2. A total of 230 patients were collected. We compared survival as outcome between patients with and without administration of TXA within 3 hours after injury. Results : Administration of TXA has significantly improved survival (P=0.033). In subgourp analysis, improved survival was significant in patients with initial levels of D-dimer 40μg/ml or more. Conclusion : Early administration of TXA significantly improved survival in patients with severe isolated traumatic brain injury. The effect of TXA is evident in the patients with hyperfibrinolysis.