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Introduction The early detection of patients at risk of massive transfusion (MT) is challenging in bleeding trauma patients [1].
Therefore, the reversal of the 'lethal triad' of acidosis, coagulopathy and accidental hypothermia is indispensable for the successful treatment of bleeding trauma patients.
The last European guidelines for the management of bleeding after severe injury [11] recommended that crystalloids should be applied initially to treat the bleeding trauma patients and that the addition of colloids should be considered in hemodynamically unstable patients.
European guidelines for bleeding care in trauma management suggest that antithrombin is not recommended in acutely bleeding trauma patients because of the increased risk of bleeding events and its failure to reduce overall mortality [40].
The objective of the present study is to assess the cost effectiveness of giving TXA to bleeding trauma patients.
Early administration of TXA to bleeding trauma patients is likely to be highly cost effective in low, middle and high income settings.
To assess the cost effectiveness of giving tranexamic acid (TXA) to bleeding trauma patients in low, middle and high income settings.
Two cost items were considered in the present study: the cost of administering TXA to bleeding trauma patients and the incremental cost of non-intensive care hospital stay.
The CRASH-2 trial showed that TXA administration reduces the risk of death in bleeding trauma patients with a small but statistically significant increase in non-intensive care stay.
Due to possible thromboembolic side effects, routine use in bleeding trauma victims is not recommended [ 30].
We suggest that crystalloids be applied initially to treat the bleeding trauma patient.
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