Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan

Tachino, Jotaro; Senoo, Shigeto; Matsumoto, Hisatake; Kitamura, Tetsuhisa; Hirayama, Atsushi; Nakao, Shunichiro; Katayama, Yusuke; Ogura, Hiroshi; Oda, Jun

doi:https://doi.org/10.1186/s13054-024-04871-w

Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan

Tachino, Jotaro; Senoo, Shigeto; Matsumoto, Hisatake et al.

Critical Care, 2024, 28, 89

Number of Access:4,675（2025-08-14 02:42 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/95649

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Title	Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan
Creator	NRID 1000050747152 1000050747152 ORCID 0000-0002-0423-7713 0000-0002-0423-7713 researchmap permalink jotarotachino jotarotachino Scopus Author ID 57203882578 57203882578 CreatorName Tachino, Jotaro
	NRID 1000030432462 1000030432462 ORCID 0000-0003-3861-6444 0000-0003-3861-6444 researchmap permalink ssenoo ssenoo Scopus Author ID 57214748425 57214748425 CreatorName Senoo, Shigeto
	NRID 1000070644003 1000070644003 researchmap permalink 38283828 38283828 Scopus Author ID 36632584800 36632584800 CreatorName Matsumoto, Hisatake
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 CreatorName Kitamura, Tetsuhisa
	NRID 1000020637350 1000020637350 researchmap permalink atsushihirayamamd atsushihirayamamd Scopus Author ID 7102401832 7102401832 CreatorName Hirayama, Atsushi
	NRID 1000080834150 1000080834150 ORCID 0000-0001-5530-806X 0000-0001-5530-806X researchmap permalink shunichironakao shunichironakao Scopus Author ID 57216959268 57216959268 CreatorName Nakao, Shunichiro
	NRID 1000050747144 1000050747144 ORCID 0000-0003-2585-4259 0000-0003-2585-4259 researchmap permalink orion2013 orion2013 Scopus Author ID 56470235000 56470235000 CreatorName Katayama, Yusuke
	NRID 1000070301265 1000070301265 researchmap permalink read0054647 read0054647 Scopus Author ID 7202495132 7202495132 CreatorName Ogura, Hiroshi
	NRID 1000060459500 1000060459500 ORCID 0000-0002-8254-3716 0000-0002-8254-3716 researchmap permalink read0068529 read0068529 Scopus Author ID 56210537000 56210537000 CreatorName Oda, Jun
Subject	Blunt trauma
	Clinical phenotype
	Nationwide cohort
	Tranexamic acid
Description	Tachino J., Seno S., Matsumoto H., et al. Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan. Critical Care 28, 89 (2024); https://doi.org/10.1186/s13054-024-04871-w.
Abstract	Background: In trauma systems, criteria for individualised and optimised administration of tranexamic acid (TXA), an antifibrinolytic, are yet to be established. This study used nationwide cohort data from Japan to evaluate the association between TXA and in-hospital mortality among all patients with blunt trauma based on clinical phenotypes (trauma phenotypes). Methods: A retrospective analysis was conducted using data from the Japan Trauma Data Bank (JTDB) spanning 2019 to 2021. Results: Of 80,463 patients with trauma registered in the JTDB, 53,703 met the inclusion criteria, and 8046 (15.0%) received TXA treatment. The patients were categorised into eight trauma phenotypes. After adjusting with inverse probability treatment weighting, in-hospital mortality of the following trauma phenotypes significantly reduced with TXA administration: trauma phenotype 1 (odds ratio [OR] 0.68 [95% confidence interval [CI] 0.57–0.81]), trauma phenotype 2 (OR 0.73 [0.66–0.81]), trauma phenotype 6 (OR 0.52 [0.39–0.70]), and trauma phenotype 8 (OR 0.67 [0.60–0.75]). Conversely, trauma phenotypes 3 (OR 2.62 [1.98–3.47]) and 4 (OR 1.39 [1.11–1.74]) exhibited a significant increase in in-hospital mortality. Conclusions: This is the first study to evaluate the association between TXA administration and survival outcomes based on clinical phenotypes. We found an association between trauma phenotypes and in-hospital mortality, indicating that treatment with TXA could potentially influence this relationship. Further studies are needed to assess the usefulness of these phenotypes. Graphical abstract: (Figure presented.)
Publisher	BioMed Central Ltd
Source Title	Critical Care
Volume (Issue)	28
Page	89
Date of Issued	2024-03-19
Language	English
Handle URL	https://hdl.handle.net/11094/95649
PISSN	13648535
eISSN	1466609X
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1186/s13054-024-04871-w
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Critical Care. 2024, 28, p. 89
DC.title	Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan
DC.creator	Tachino, Jotaro
	Senoo, Shigeto
	Matsumoto, Hisatake
	Kitamura, Tetsuhisa
	Hirayama, Atsushi
	Nakao, Shunichiro
	Katayama, Yusuke
	Ogura, Hiroshi
	Oda, Jun
DC.publisher	BioMed Central Ltd
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2024-03-19
DC.identifier	https://doi.org/10.1186/s13054-024-04871-w
DC.subject	Blunt trauma
	Clinical phenotype
	Nationwide cohort
	Tranexamic acid
DC.description	Tachino J., Seno S., Matsumoto H., et al. Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan. Critical Care 28, 89 (2024); https://doi.org/10.1186/s13054-024-04871-w.
DCTERMS.abstract	Background: In trauma systems, criteria for individualised and optimised administration of tranexamic acid (TXA), an antifibrinolytic, are yet to be established. This study used nationwide cohort data from Japan to evaluate the association between TXA and in-hospital mortality among all patients with blunt trauma based on clinical phenotypes (trauma phenotypes). Methods: A retrospective analysis was conducted using data from the Japan Trauma Data Bank (JTDB) spanning 2019 to 2021. Results: Of 80,463 patients with trauma registered in the JTDB, 53,703 met the inclusion criteria, and 8046 (15.0%) received TXA treatment. The patients were categorised into eight trauma phenotypes. After adjusting with inverse probability treatment weighting, in-hospital mortality of the following trauma phenotypes significantly reduced with TXA administration: trauma phenotype 1 (odds ratio [OR] 0.68 [95% confidence interval [CI] 0.57–0.81]), trauma phenotype 2 (OR 0.73 [0.66–0.81]), trauma phenotype 6 (OR 0.52 [0.39–0.70]), and trauma phenotype 8 (OR 0.67 [0.60–0.75]). Conversely, trauma phenotypes 3 (OR 2.62 [1.98–3.47]) and 4 (OR 1.39 [1.11–1.74]) exhibited a significant increase in in-hospital mortality. Conclusions: This is the first study to evaluate the association between TXA administration and survival outcomes based on clinical phenotypes. We found an association between trauma phenotypes and in-hospital mortality, indicating that treatment with TXA could potentially influence this relationship. Further studies are needed to assess the usefulness of these phenotypes. Graphical abstract: (Figure presented.)
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	95649
citation_title	Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan
citation_author	Tachino, Jotaro
	Senoo, Shigeto
	Matsumoto, Hisatake
	Kitamura, Tetsuhisa
	Hirayama, Atsushi
	Nakao, Shunichiro
	Katayama, Yusuke
	Ogura, Hiroshi
	Oda, Jun
citation_publisher	BioMed Central Ltd
citation_language	English
citation_date	2024-03-19
citation_journal_title	Critical Care
citation_volume	28
citation_firstpage	89
citation_doi	https://doi.org/10.1186/s13054-024-04871-w
citation_public_url	https://hdl.handle.net/11094/95649

Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan

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