6/28/23, 12:21 AM CRASH-2 Pathway Feedback Search Clinical Topics Home Studies CRASH 2 CRASH 2 Disease Traumatic hemorrhage Trial question What is the effect of tranexamic acid in trauma patients with significant hemorrhage? Study design Multi-center Double blinded RCT Population Characteristics of study participants 16.0% female N = 20211 84.0% male 20211 patients (3271 female, 16908 male) Inclusion criteria: adult trauma patients with, or at risk of, significant bleeding Key exclusion criteria: a clear indication for tranexamic acid, or a clear contraindication to tranexamic acid treatment Interventions N=10096 tranexamic acid (loading dose 1 g over 10 min then infusion of 1 g over 8 h IV) N=10115 placebo (matching placebo of 0.9% saline IV) Primary outcome All-cause death 16.0 % 16 14.5 12.0 % 8.0 % Si ifi t d https://web.pathway.md/studies/recU6k0jaHCrofV2P 1/2 6/28/23, 12:21 AM CRASH-2 Pathway Significant decrease 4.0 % NNT = 67 0.0 % Tranexamic acid Placebo Significant decrease in all-cause death (14.5% vs. 16%; RR 0.91, 95% CI 0.85 to 0.97) Secondary outcomes Significant decrease in death due to bleeding (4.9% vs. 5.7%; RR 0.85, 95% CI 0.76 to 0.96) No significant difference in death due to vascular occlusion (0.3% vs. 0.5%; RR 0.9, 95% CI 0.75 to 1.08) No significant difference in vascular occlusive events (1.7% vs. 2%; RR 0.84, 95% CI 0.68 to 1.02) Conclusion In adult trauma patients with, or at risk of, significant bleeding, tranexamic acid was superior to placebo with respect to a all-cause death. Reference CRASH- trial collaborators, Shakur H, Roberts I et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3;376(9734):23-32. Open reference URL https://web.pathway.md/studies/recU6k0jaHCrofV2P 2/2