USE OF TRANEXAMIC ACID IN TRAUMA PATIENTS: AN ANALYSIS OF COST-EFFECTIVENESS FOR USE IN BRAZIL

Detalhes bibliográficos
Autor(a) principal: PINTO,Marcelo A.
Data de Publicação: 2016
Outros Autores: SILVA,Jair G. da, CHEDID,Aljamir D., CHEDID,Marcio F.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202016000400282
Resumo: ABSTRACT Introduction: Use of tranexamic acid (TXA) in trauma has been the subject of growing interest by researchers and health professionals. However, there are still several open questions regarding its use. In some aspects medical literature is controversial. The points of disagreement among experts include questions such as: Which patients should receive TXA in trauma? Should treatment be performed in the pre-hospital environment? Is there any need for laboratory parameters before starting TXA treatment? What is the drug safety profile? The main issue on which there is still no basis in literature is: What is the indication for treatment within massive transfusion protocols? Objective: Answer the questions proposed based on critical evaluation of the evidence gathered so far and carry out a study of cost-effectiveness of TXA use in trauma adapted to the Brazilian reality. Methods: A literature review was performed through searching Pubmed.com, Embase and Cab Abstract by headings "tranexamic AND trauma", in all languages, yielding 426 articles. Manuscripts reporting on TXA utilization for elective procedures were excluded, remaining 79 articles. Fifty-five articles were selected, and critically evaluated in order to answer study questions. The evaluation of cost effectiveness was performed using CRASH-2 trial data and Brazilian official population data. Results: TXA is effective and efficient, and should be administered to a wide range of patients, including those with indication evaluated in research protocols and current indication criteria for TXA should be expanded. As for the cost-effectiveness, the TXA proved to be cost-effective with an average cost of R$ 61.35 (currently US$16) per year of life saved. Conclusion: The use of TXA in trauma setting seems to be effective, efficient and cost-effective in the various groups of polytrauma patients. Its use in massive transfusion protocols should be the subject of further investigations.
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spelling USE OF TRANEXAMIC ACID IN TRAUMA PATIENTS: AN ANALYSIS OF COST-EFFECTIVENESS FOR USE IN BRAZILacidTraumaSchockOperationCoagulopathyCost-benefit analysis.ABSTRACT Introduction: Use of tranexamic acid (TXA) in trauma has been the subject of growing interest by researchers and health professionals. However, there are still several open questions regarding its use. In some aspects medical literature is controversial. The points of disagreement among experts include questions such as: Which patients should receive TXA in trauma? Should treatment be performed in the pre-hospital environment? Is there any need for laboratory parameters before starting TXA treatment? What is the drug safety profile? The main issue on which there is still no basis in literature is: What is the indication for treatment within massive transfusion protocols? Objective: Answer the questions proposed based on critical evaluation of the evidence gathered so far and carry out a study of cost-effectiveness of TXA use in trauma adapted to the Brazilian reality. Methods: A literature review was performed through searching Pubmed.com, Embase and Cab Abstract by headings "tranexamic AND trauma", in all languages, yielding 426 articles. Manuscripts reporting on TXA utilization for elective procedures were excluded, remaining 79 articles. Fifty-five articles were selected, and critically evaluated in order to answer study questions. The evaluation of cost effectiveness was performed using CRASH-2 trial data and Brazilian official population data. Results: TXA is effective and efficient, and should be administered to a wide range of patients, including those with indication evaluated in research protocols and current indication criteria for TXA should be expanded. As for the cost-effectiveness, the TXA proved to be cost-effective with an average cost of R$ 61.35 (currently US$16) per year of life saved. Conclusion: The use of TXA in trauma setting seems to be effective, efficient and cost-effective in the various groups of polytrauma patients. Its use in massive transfusion protocols should be the subject of further investigations.Colégio Brasileiro de Cirurgia Digestiva2016-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202016000400282ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.29 n.4 2016reponame:ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)instname:Colégio Brasileiro de Cirurgia Digestiva (CBCD)instacron:CBCD10.1590/0102-6720201600040017info:eu-repo/semantics/openAccessPINTO,Marcelo A.SILVA,Jair G. daCHEDID,Aljamir D.CHEDID,Marcio F.eng2017-01-06T00:00:00Zoai:scielo:S0102-67202016000400282Revistahttp://abarriguda.org.br/revista/index.php/revistaabarrigudaarepb/indexONGhttps://old.scielo.br/oai/scielo-oai.php||revistaabcd@gmail.com2317-63262317-6326opendoar:2017-01-06T00:00ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) - Colégio Brasileiro de Cirurgia Digestiva (CBCD)false
dc.title.none.fl_str_mv USE OF TRANEXAMIC ACID IN TRAUMA PATIENTS: AN ANALYSIS OF COST-EFFECTIVENESS FOR USE IN BRAZIL
title USE OF TRANEXAMIC ACID IN TRAUMA PATIENTS: AN ANALYSIS OF COST-EFFECTIVENESS FOR USE IN BRAZIL
spellingShingle USE OF TRANEXAMIC ACID IN TRAUMA PATIENTS: AN ANALYSIS OF COST-EFFECTIVENESS FOR USE IN BRAZIL
PINTO,Marcelo A.
acid
Trauma
Schock
Operation
Coagulopathy
Cost-benefit analysis.
title_short USE OF TRANEXAMIC ACID IN TRAUMA PATIENTS: AN ANALYSIS OF COST-EFFECTIVENESS FOR USE IN BRAZIL
title_full USE OF TRANEXAMIC ACID IN TRAUMA PATIENTS: AN ANALYSIS OF COST-EFFECTIVENESS FOR USE IN BRAZIL
title_fullStr USE OF TRANEXAMIC ACID IN TRAUMA PATIENTS: AN ANALYSIS OF COST-EFFECTIVENESS FOR USE IN BRAZIL
title_full_unstemmed USE OF TRANEXAMIC ACID IN TRAUMA PATIENTS: AN ANALYSIS OF COST-EFFECTIVENESS FOR USE IN BRAZIL
title_sort USE OF TRANEXAMIC ACID IN TRAUMA PATIENTS: AN ANALYSIS OF COST-EFFECTIVENESS FOR USE IN BRAZIL
author PINTO,Marcelo A.
author_facet PINTO,Marcelo A.
SILVA,Jair G. da
CHEDID,Aljamir D.
CHEDID,Marcio F.
author_role author
author2 SILVA,Jair G. da
CHEDID,Aljamir D.
CHEDID,Marcio F.
author2_role author
author
author
dc.contributor.author.fl_str_mv PINTO,Marcelo A.
SILVA,Jair G. da
CHEDID,Aljamir D.
CHEDID,Marcio F.
dc.subject.por.fl_str_mv acid
Trauma
Schock
Operation
Coagulopathy
Cost-benefit analysis.
topic acid
Trauma
Schock
Operation
Coagulopathy
Cost-benefit analysis.
description ABSTRACT Introduction: Use of tranexamic acid (TXA) in trauma has been the subject of growing interest by researchers and health professionals. However, there are still several open questions regarding its use. In some aspects medical literature is controversial. The points of disagreement among experts include questions such as: Which patients should receive TXA in trauma? Should treatment be performed in the pre-hospital environment? Is there any need for laboratory parameters before starting TXA treatment? What is the drug safety profile? The main issue on which there is still no basis in literature is: What is the indication for treatment within massive transfusion protocols? Objective: Answer the questions proposed based on critical evaluation of the evidence gathered so far and carry out a study of cost-effectiveness of TXA use in trauma adapted to the Brazilian reality. Methods: A literature review was performed through searching Pubmed.com, Embase and Cab Abstract by headings "tranexamic AND trauma", in all languages, yielding 426 articles. Manuscripts reporting on TXA utilization for elective procedures were excluded, remaining 79 articles. Fifty-five articles were selected, and critically evaluated in order to answer study questions. The evaluation of cost effectiveness was performed using CRASH-2 trial data and Brazilian official population data. Results: TXA is effective and efficient, and should be administered to a wide range of patients, including those with indication evaluated in research protocols and current indication criteria for TXA should be expanded. As for the cost-effectiveness, the TXA proved to be cost-effective with an average cost of R$ 61.35 (currently US$16) per year of life saved. Conclusion: The use of TXA in trauma setting seems to be effective, efficient and cost-effective in the various groups of polytrauma patients. Its use in massive transfusion protocols should be the subject of further investigations.
publishDate 2016
dc.date.none.fl_str_mv 2016-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202016000400282
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/0102-6720201600040017
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dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Colégio Brasileiro de Cirurgia Digestiva
publisher.none.fl_str_mv Colégio Brasileiro de Cirurgia Digestiva
dc.source.none.fl_str_mv ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.29 n.4 2016
reponame:ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
instname:Colégio Brasileiro de Cirurgia Digestiva (CBCD)
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instname_str Colégio Brasileiro de Cirurgia Digestiva (CBCD)
instacron_str CBCD
institution CBCD
reponame_str ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
collection ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
repository.name.fl_str_mv ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) - Colégio Brasileiro de Cirurgia Digestiva (CBCD)
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