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The CRASH-2 trial showed that the antifibrinolytic agent tranexamic acid reduced mortality in adult trauma patients with extracranial hemorrhage, without increasing vascular occlusions (JW Emerg Med Jun 15 2010). In a planned substudy, researchers assessed the effect of tranexamic acid in a cohort of CRASH-2 patients with traumatic brain injury (TBI; Glasgow Coma Scale score ≤14).
In the CRASH-2 trial, 20,111 patients with or at risk for significant extracranial hemorrhage were randomized to receive tranexamic acid (loading dose of 1g over 10 minutes followed by an infusion of 1 g over 8 hours) or placebo within 8 hours of injury. The substudy involved 123 patients with TBI who were randomized to tranexamic acid and 126 patients with TBI who…