The Use of Tranexamic Acid for Traumatic Brain Injury with Contusions or Traumatic Subarachnoid Haemorrhage in the Elderly

Abstract

Objective:

To investigate the impact of Tranexamic Acid (TXA) as an initial non-operative treatment on the mortality rate of traumatic brain injury with contusions or traumatic subarachnoid haemorrhage in the elderly.

Method:

This was a seven-year retrospective study of consecutive patients admitted for traumatic brain injury with contusions or traumatic subarachnoid haemorrhage at Queen Mary Hospital from 2010-2016. Primary outcome was the overall mortality rate. Secondary outcomes included rate of deterioration requiring operation and the survival rate without operations.

Result:

In total 651 consecutive patients were identified. 81 patients had TXA (TXA group) while 570 did not have TXA (control group) during admission. The average age was 73.92 years old (95%CI 68.77-77.84 years old) for the TXA group versus 65.36 years old (95%CI 63.24-67.48 years old) for the control group (p=0.0062). The overall mortality rate with TXA was 7.40% versus 8.77% in the control group (OR 0.832 95%CI 0.345-2.007, p=0.682). The rate of deterioration requiring operation in the TXA group was 6.17% versus 16.3% in the control group (OR 0.337 95%CI 0.133-0.857, p=0.022). The survival rate with no operations in the TXA group was 88.89% versus 77.89% in the control group (OR 2.270 95%CI 1.104-4.667, p=0.026).

Conclusion:

In this study, patients in the TXA group was significantly older than that in the control group. The overall mortality rates were comparable in the two groups. The TXA group had a lower rate of operation. With the use of Tranexamic Acid, there were significantly more survivors without operations.