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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."