Studeo
17th June 2010, 19:22
Simple Injection Could Save the Lives of Thousands of Accident Victims Worldwide
http://www.sciencedaily.com/releases/2010/06/100614205419.htm
ScienceDaily (June 15, 2010) — If recently injured patients with
serious bleeding were to receive a cheap, widely available and easily
administered drug to help their blood to clot, tens of thousands of
lives could be saved every year, according to a paper published
on-line by The Lancet.
Dr Ian Roberts, Professor of Epidemiology at the London School of
Hygiene and Tropical Medicine (LSHTM), UK, revealed that results from
a trial show that early administration of tranexamic acid (TXA) to
patients with recent, severe bleeding injuries saves lives, with no
evidence of adverse effects from unwanted clotting.
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. This is the first trial of TXA
in injured patients, although smaller trials have shown that it
reduces bleeding in patients undergoing major surgery.
TXA is an off-patent drug, manufactured by a number of different
companies. The cost per gram is about £3 ($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. "Each year about 600,000 injured
patients bleed to death worldwide," said Professor Roberts. "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. Although most deaths from injuries are
in developing countries, injury is a leading cause of death in young
adults throughout the world."
He continues, "It's important to remember that deaths from injuries
are increasing around the world and that they usually involve young
adults, often the main breadwinner in the family. The impact on the
family is devastating."
Severely injured adults were enrolled in the trial if they had
significant bleeding, or were at risk of significant bleeding and were
within a few hours of injury. 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 numbers 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 researchers estimate 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 USA and more in Europe.
"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. We
believe that doctors across the world should now consider using it to
improve accident victims' chances of survival and that it should be
considered for inclusion in the WHO List of Essential Medicines,"
Professor Roberts concluded.
Dr. Etienne Krug, Director of Violence and Injury Prevention and
Disability at WHO said, "Across the world, injuries kill more than
five million people each year and leave millions more permanently
disabled. The economic and social cost of injury is enormous, with
most of the burden in low and middle income countries.
"Prevention is critical, but even with the best efforts there will
still be millions of patients requiring emergency treatment, which is
why these results are so important. The drug is inexpensive and could
be given in hospitals world-wide. It is essential that doctors are
aware of these results and take them into account in the emergency
management of seriously injured patients."
Earl Howe, Health Minister said: "I am delighted that through the
National Institute for Health Research, the Department of Health has
funded this research which shows that TXA can be used safely on
patients with recent, severe bleeding caused by injury.
"This is a great example of how important research can help the NHS
save more lives and spread best practice around the world."
Story Source:
The above story is reprinted (with editorial adaptations by
ScienceDaily staff) from materials provided by London School of
Hygiene & Tropical Medicine (LSHTM), via AlphaGalileo.
http://www.sciencedaily.com/releases/2010/06/100614205419.htm
ScienceDaily (June 15, 2010) — If recently injured patients with
serious bleeding were to receive a cheap, widely available and easily
administered drug to help their blood to clot, tens of thousands of
lives could be saved every year, according to a paper published
on-line by The Lancet.
Dr Ian Roberts, Professor of Epidemiology at the London School of
Hygiene and Tropical Medicine (LSHTM), UK, revealed that results from
a trial show that early administration of tranexamic acid (TXA) to
patients with recent, severe bleeding injuries saves lives, with no
evidence of adverse effects from unwanted clotting.
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. This is the first trial of TXA
in injured patients, although smaller trials have shown that it
reduces bleeding in patients undergoing major surgery.
TXA is an off-patent drug, manufactured by a number of different
companies. The cost per gram is about £3 ($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. "Each year about 600,000 injured
patients bleed to death worldwide," said Professor Roberts. "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. Although most deaths from injuries are
in developing countries, injury is a leading cause of death in young
adults throughout the world."
He continues, "It's important to remember that deaths from injuries
are increasing around the world and that they usually involve young
adults, often the main breadwinner in the family. The impact on the
family is devastating."
Severely injured adults were enrolled in the trial if they had
significant bleeding, or were at risk of significant bleeding and were
within a few hours of injury. 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 numbers 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 researchers estimate 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 USA and more in Europe.
"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. We
believe that doctors across the world should now consider using it to
improve accident victims' chances of survival and that it should be
considered for inclusion in the WHO List of Essential Medicines,"
Professor Roberts concluded.
Dr. Etienne Krug, Director of Violence and Injury Prevention and
Disability at WHO said, "Across the world, injuries kill more than
five million people each year and leave millions more permanently
disabled. The economic and social cost of injury is enormous, with
most of the burden in low and middle income countries.
"Prevention is critical, but even with the best efforts there will
still be millions of patients requiring emergency treatment, which is
why these results are so important. The drug is inexpensive and could
be given in hospitals world-wide. It is essential that doctors are
aware of these results and take them into account in the emergency
management of seriously injured patients."
Earl Howe, Health Minister said: "I am delighted that through the
National Institute for Health Research, the Department of Health has
funded this research which shows that TXA can be used safely on
patients with recent, severe bleeding caused by injury.
"This is a great example of how important research can help the NHS
save more lives and spread best practice around the world."
Story Source:
The above story is reprinted (with editorial adaptations by
ScienceDaily staff) from materials provided by London School of
Hygiene & Tropical Medicine (LSHTM), via AlphaGalileo.