In the CRASH-2 trial, tranexamic acid was shown to reduce mortality in trauma patients when given within 3 hours of injury. Administration beyond 3 hours resulted in:
- A No effect on mortality
- B Increased mortality, particularly from haemorrhage ✓
- C Increased rate of pulmonary embolism
- D Modest reduction in mortality still observed
Correct answer: B. Increased mortality, particularly from haemorrhage
Explanation
The CRASH-2 trial showed that tranexamic acid administered within 1 hour of injury gave the greatest mortality reduction (32% RRR), within 1–3 hours gave a moderate reduction, but administration after 3 hours of injury paradoxically increased mortality from haemorrhage. This time-dependency underlines the importance of early administration and the role of fibrinolysis timing in trauma coagulopathy.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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