Association of cryoprecipitate and tranexamic acid with improved survival following wartime injury findings from the MATTERs II study

Jonathan J. Morrison, James Ross, Joseph J. Dubose, Jan O. Jansen, Mark J. Midwinter, Todd E. Rasmussen

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

Objective: To quantify the impact of fibrinogencontaining cryoprecipitate in addition to the antifibrinolytic tranexamic acid on survival in combat injured. Design: Retrospective observational study comparing the mortality of4groups: tranexamic acid only, cryoprecipitate only, tranexamicacidandcryoprecipitate,andneithertranexamicacidnorcryoprecipitate. Tobalance comparisons, propensity scores were developed and added as covariates to logistic regression models predicting mortality. Setting: A Role 3 Combat Surgical Hospital in southern Afghanistan. Patients: A total of 1332 patients were identified from prospectively collected UK and US trauma registries who required 1 U or more of packed red blood cells and composed the following groups: tranexamic acid (n=148), cryoprecipitate (n=168), tranexamic acid/cryoprecipitate (n=258), and no tranexamic acid/cryoprecipitate (n=758). Main Outcome Measure: In-hospital mortality. Results: Injury Severity Scores were highest in the cryoprecipitate (mean [SD], 28.3 [15.7]) and tranexamic acid/ cryoprecipitate (mean [SD], 26 [14.9]) groups compared with the tranexamic acid (mean [SD], 23.0 [19.2]) and no tranexamic acid/cryoprecipitate (mean [SD], 21.2 [18.5]) (P

Original languageEnglish (US)
Pages (from-to)218-225
Number of pages8
JournalJAMA Surgery
Volume148
Issue number3
DOIs
StatePublished - Mar 2013
Externally publishedYes

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Tranexamic Acid
Survival
Wounds and Injuries
Logistic Models
Afghanistan
Propensity Score
Antifibrinolytic Agents
Injury Severity Score
Mortality
Hospital Mortality
Observational Studies
Registries
Retrospective Studies
Erythrocytes
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Surgery

Cite this

Association of cryoprecipitate and tranexamic acid with improved survival following wartime injury findings from the MATTERs II study. / Morrison, Jonathan J.; Ross, James; Dubose, Joseph J.; Jansen, Jan O.; Midwinter, Mark J.; Rasmussen, Todd E.

In: JAMA Surgery, Vol. 148, No. 3, 03.2013, p. 218-225.

Research output: Contribution to journalArticle

Morrison, Jonathan J. ; Ross, James ; Dubose, Joseph J. ; Jansen, Jan O. ; Midwinter, Mark J. ; Rasmussen, Todd E. / Association of cryoprecipitate and tranexamic acid with improved survival following wartime injury findings from the MATTERs II study. In: JAMA Surgery. 2013 ; Vol. 148, No. 3. pp. 218-225.
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