A 24-year-old man sustains blunt abdominal trauma in a road traffic accident and is found to have significant intra-abdominal hemorrhage. He presents within 90 minutes of injury. According to the CRASH-2 trial, administration of tranexamic acid in this scenario is associated with which outcome?

• A Increased risk of venous thromboembolism
• B Reduction in traumatic brain injury mortality only
• C No significant difference in transfusion requirements
• D Reduction in all-cause mortality if given within 3 hours ✓

Explanation

The CRASH-2 trial demonstrated that tranexamic acid reduces all-cause mortality in traumatic hemorrhage when given within 3 hours of injury, with earlier treatment being more beneficial. It is an antifibrinolytic that inhibits plasminogen activation. When given beyond 3 hours, mortality may increase. Venous thromboembolism risk was not significantly increased. The benefit was seen in hemorrhage overall, not limited to traumatic brain injury.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.