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Saving up to 100,000 Lives

The researchers estimate that TXA could prevent between 70,000 and 100,000 deaths worldwide if it were readily available for trauma victims. In India it could save about 13,000 lives each year, and in China, 12,000. The medication could also have a dramatic impact on deaths in developed countries, with about 2,000 lives saved each year in the U.S. and more across Europe.

"Patients with severe injuries die very soon after their injuries," Roberts told the press conference, held at the London School of Hygiene and Tropical Medicine. Sixty percent of people who die after injury do so on the first day, Roberts said. "People bleed to death in the emergency department, so this is an emergency treatment."

The researchers conclude: "Tranexamic acid could be given in a wide range of health-care settings, and safely reduced the risk of death in bleeding trauma patients in our study. The option to use tranexamic acid should be available to doctors treating trauma patients in all countries, and this drug should be considered for inclusion on the WHO List of Essential Medicines."

The research is published in the Online First edition of The Lancet. It was funded by England's National Institute for Health Research (NIHR) Health Technology Assessment programme.

In an accompanying editorial, Jerrold H. Levy, MD, of Emory University School of Medicine in Atlanta, writes: "Today's study shows that inhibition of fibrinolysis [the process in which a blood clot is broken down] with tranexamic acid after major trauma is an important mechanism to reduce mortality. ... However, caution is needed before extrapolation of the results of CRASH-2 to other antifibrinolytic agents until they have been studied in a similarly robust manner."

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