Tens of thousands of accident victims can be saved worldwide every year if they are administered a cheap, widely available and easily administered drug to help their blood clot, according to a new study.
The results from the trial show that early administration of tranexamic acid (TXA) to patients with recent, severe bleeding injuries saves lives, with no signs of adverse effects from unwanted clotting, said Ian Roberts from London School of Hygiene and Tropical Medicine (LSHTM).
The researchers estimated that administering TXA soon after injury could prevent up to 100,000 deaths per year across the world. In India, it could save about 13,000 lives each year, with about 12,000 lives saved in China.
The drug would also save lives in developed countries, around 2,000 each year in the US and more in Europe.
"Each year, about 600,000 injured patients bleed to death worldwide," said Roberts, professor of epidemiology, who led the study.
"Injuries may be accidental, for example traffic crashes, or intentional, such as shootings, stabbings or land mine injuries and the majority of deaths occur soon after injury," he said.
The trial, named CRASH-2, was a large, randomised trial involving over 20,000 adult patients in 274 hospitals across 40 countries, and was funded by England's National Institute for Health Research (NIHR) Health Technology Assessment programme.
TXA is an off-patent drug, manufactured by a number of different companies. The cost per gram is about three pounds ($4.50).
The drug helps by reducing clot breakdown. Although this would be advantageous in patients with severe bleeding, doctors were worried that TXA might increase the risk of complications, such as heart attacks, strokes and clots in the lungs.
The results of this large trial show that TXA reduces death from bleeding without any increase in these complications. For people aged between five and 45 years, injury is second only to HIV/AIDS as a cause of death.
They were randomly allocated to receive either one gram of TXA by injection, followed by another one gram in a drip over the following eight hours, or a matching placebo.
The researchers studied the number of deaths in hospital within four weeks of injury in the two groups and found that TXA reduced the chances of death due to massive blood loss by about one sixth.
"The large numbers of patients treated in very different healthcare settings around the world means we can be sure that prompt use of TXA will be of benefit to trauma patients in all kinds of facilities," Roberts concluded, according to an LSHTM release.