BACKGROUND: @entity548 is responsible for about a third of in-hospital @entity130 deaths. The CRASH-2 trial demonstrated that early administration of @entity927 , ideally within 3 hours, can reduce mortality from @entity130 -associated @entity548 by up to 32%. OBJECTIVE: To explore whether, in our @entity130 network in a middle-income country, @entity1 arrived at hospital soon enough after injury for @entity927 administration to be effective and safe. METHODS: A prospective cohort study of 50 consecutive @entity1 admitted to our @entity130 unit was undertaken. Inclusion criteria were as for the CRASH-2 study: systolic blood pressure <90 mmHg and/or heart rate >110 beats per minute, with injuries suggestive of a risk of @entity548 . @entity1 with isolated @entity542 were excluded. The mechanisms of injury, time since injury and any reasons for delay were recorded. RESULTS: Thirteen (26%) @entity1 presented early enough for @entity927 administration. Of these, only three @entity1 presented within the 1st hour. Eleven @entity1 had a documented time of injury >3 hours prior to presentation. We were unsure of the time of injury for 26 @entity1 , although for most of these it was likely to be >3 hours before presentation. CONCLUSIONS: The majority (74%) of @entity548 @entity130 @entity1 did not present within the timeframe allowed for safe administration of tranexamic therapy. Of those who did, most would have benefited from even earlier commencement of therapy. This raises the possibility that @entity927 may be more effective on a population basis if incorporated into prehospital rather than in-hospital protocols; future studies should explore the benefits and risks of this approach.

Time since injury is the major factor in preventing @entity927 use in the @entity130 setting: An observational cohort study from a major XXXX centre in a middle-income country.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding', 'haemorrhage', 'Haemorrhage'] @entity542 :: ('MESH:D006259', 'Disease') :: ['head injuries'] @entity927 :: ('MESH:D014148', 'Chemical') :: ['tranexamic acid'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity130 :: (MESH:D014947,Disease) :: ['trauma']
