Empiric Use of TXA in Geriatric Trauma is Not Associated With Blood Product Utilization, Survival, or VTE Incidence

Document Type

Article

Publication Date

7-22-2026

Institution/Department

Surgery

Journal Title

The Journal of surgical research

Abstract

INTRODUCTION: The benefits of the empiric use of tranexamic acid (TXA) in geriatric trauma patients remain to be elucidated. Our study objectives were to examine any association with TXA treatment with thromboembolic complications, blood product utilization, mortality, and hospital outcomes. METHODS: Retrospective registry review of a single rural level 1 trauma center of patients ≥65 years of age who received empiric TXA between January 1, 2014 and July 30, 2024 were studied. A matched cohort for injury severity score, abbreviated injury scale (AIS) for all body regions, gender, age, and those who received >1 unit of blood product control group were used in a 2:1 paired case-control study. RESULTS: Twenty-one geriatric patients received empiric TXA. There was no difference in age, yrs (78 ± 7.1; 78.6 ± 8.4, P = 0.38), gender (P = 1), mechanism of injury, median injury severity score (17 [IQR 11.5, 22]; 17 [ IQR 9, 29], P = 0.28), median AIS head (3 [IQR 3, 4]; 3 [IQR 1, 5], P = 0.27), median AIS thorax (3 [IQR 2, 3]; 3 [IQR 2, 3], P = 0.37), median AIS abdomen (2 [IQR 1, 4]; 3 [IQR 2, 4]; P = 0.17); median AIS spine (2 [IQR 2, 2.75]; 2 [IQR 2, 3], P = 0.50); median AIS upper extremity (1 [IQR 1, 2]; 1 [IQR 1, 2], P = 0.27), median AIS lower extremity (2 [ IQR 1, 3]; 3 [IQR 1, 3], P = 0.38), Glasgow coma score (11.7 ± 4.8; 12 ± 4.8, P = 0.41), thromboembolic complications (P = 0.13), blood product utilization (P = 0.07), mortality (P = 1), ICU length of stay (P = 0.23), and hospital length of stay (P = 0.16). CONCLUSIONS: TXA was not associated with changes in mortality, VTE, or blood product use in geriatric trauma.

First Page

434

Last Page

438

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